THE HEALTH -CARE 

OF THE 

GROWING CHILD 



LOUIS FISCHER, M.D. 



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THE HEALTH-CARE OF THE 
GROWING CHILD 



A COMPANION VOLUME TO THIS 
BY THE SAME AUTHOR 



The Health-Care 
of the Baby 

A most useful Handbook for Mothers 
and Nurses 

Tells about feeding, teething, bathing, clothing, 
accidents, skin diseases, bad habits, scarlet fever, 
diphtheria, whooping cough, measles, croup, colic, 
worms, and tonsilitis. 

COMMENDATIONS 

"Dr. Fischer's experience as a specialist in the 
treatment of children's diseases gives the stamp of 
authority to this handbook for mothers and nurses." 
— Chronicle Telegraph, Pittsburg. 

"Written so simply and plainly that it can be 
readily understood by even the most inexperi- 
enced." — Brooklyn Citizen. 

"Such a book in the hands of a mother, especially a 
young mother, is invaluable." — Baltimore Methodist. 

"A very valuable addition to the household's 
essentials." — The Citizen, Brooklyn. 

12mo, Cloth. 75 cents, net; by mail, 82 cents 



FUNK & WAGNALLS COMPANY, Publishers 
NEW YORK and LONDON 



THE HEALTH-CARE OF 
THE GROWING CHILD 

HIS DIET—HYGIENE— TRAINI 
DEVELOPMENT AND 
PREVENT!*' F DISEASE 

TAOflHT YHTJA3H JIO JAMflOM A 
LOUIS iER, M.D. 

AUTHOR OF "THE I; tB BABY, DING 

IN HEALTH AND i iN " 

FAN) 

OF THE BABIES' WARDS lL - AND 

THE WILLARr; 
FORMEB TOR IN I SN 

AT THE NEW YORK PO 




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A NORMAL OR HEALTHY THROAT 



THE THROAT IN TONSILITIS 

Note the yellowish-white spots on the swollen tonsils, 
hanging between the tonsils is the swollen and congested 
uvula or soft palate. The tongue appears coated. 



THE HEALTH-CARE OF 
THE GROWING CHILD 

HIS DIET— HYGIENE— TRAINING- 
DEVELOPMENT AND 
PREVENTION OF DISEASE 

BY 

LOUIS FISCHER, M.D. 

AUTHOR OF "THE HEALTH-CAKE OF THE BABY," "INFANT FEEDING 
IN HEALTH AND DISEASE," "a TEXT-BOOK ON DISEASES OF IN- 
FANCY AND CHILDHOOD;" ATTENDING PHYSICIAN IN CHARGE 
OF THE BABIES' WARDS OF SYDENHAM HOSPITAL, AND 
TO THE WILLARD PARKER AND RIVERSIDE HOSPITALS; 
FORMER INSTRUCTOR IN DISEASES OF CHILDREN 
AT THE NEW YORK POST GRADUATE MEDICAL 
SCHOOL AND HOSPITAL, ETC. 




FUNK & WAGNALLS COMPANY 

NEW YORK AND LONDON 

1915 



TO 



Copyright, 1915, by 

FUNK & WAGNALLS COMPANY 

(Printed in the United States of America) 



Published* October, 1915 




NOV 20 1915 



)CI,A4 16497 



3Sebicateto 
So tfie parents 

of 
"Utttle WW 



PREFACE 

The main object of this book is to in- 
struct and guide the intelligent mother 
when remote from her physician, or to ad- 
vise her sufficiently in case of emergency 
until medical help is required and can be 
procured. 

Our methods of feeding, hygiene, gym- 
nastics, development, school life, and home- 
training are so vastly different from what 
they were one decade ago that every mother 
who wishes to keep up to date needs must 
read. 

So many conditions may be met with in 
daily routine that the average mother is 
likely to be bewildered and perplexed un- 
less she has a guide near her. Every 
mother should know the appearance of a 

[vii] 



PKEFACE 

healthy throat and of an inflamed throat. 
She should know the symptoms of adenoids 
and familiarize herself with rashes due to 
inflammatory and also to non-inflammatory 
conditions within the body. She should 
know the normal temperature and recog- 
nize fever by her thermometer. 

Faulty position while sitting at home or 
at school, if continued, may develop spinal 
curvature or round shoulders. To obviate 
this a series of exercises is provided which 
show how this faulty development may be 
corrected. The importance of correcting 
this deformity early in life will be appre- 
ciated, for if it be not checked, spinal ap- 
paratus and plaster of Paris casts may 
ultimately be required. 

Headache is frequently due to eye-strain, 
but there are many other causes of head- 
ache in boys and girls. These are specified 
in detail. 

[ viii 1 



PEEFACE 

Sex-hygiene is so described that every 
mother can understand this delicate prob- 
lem. What to avoid, and how to instruct 
boys and girls to prevent habits which may 
affect their future, and especially under- 
mine their nervous system, are explained in 
detail. 

The communicable diseases, their dan- 
gers, complications, and modern methods 
of quarantine are considered and presented 
from the modern viewpoint. Disinfection, 
as formerly used, is now abandoned, and 
modern sanitation and isolation have been 
described with deference to modern views. 

Many illustrations showing the value of 
gymnastics, intended for the development 
of the spine, the chest, the neck, the arms, 
and the legs, have been added. Weak ankles 
and defective walking are illustrated. 

The adenoid expression so frequently 
noted in school children has been depicted 

[ix] 



PKEFACE 

and described. This adenoid condition 
should receive the close attention of every 
mother. 

The most important illustrations show 
clearly how to recognize measles, chicken- 
pox, and smallpox. The throat is the seat 
of more trouble than any other part of the 
human body. Studies of a normal throat 
and of a diseased throat, showing yellow- 
ish spots on the tonsils, have been in- 
cluded. 

Trachoma, which is regarded as one of 
the most treacherous of eye-diseases, and 
for which every medical inspector exam- 
ines, is shown in such manner as to be 
unmistakable. In addition, the tapeworm, 
showing both segments and head, is in- 
cluded. 

Enlarged glands are sometimes an early 
symptom of tuberculosis; this should be 
well remembered. Ivy poison is a frequent 

[*3 



PREFACE 

source of irritation in school children, 
hence every mother should know and be 
able to teach her child the difference be- 
tween poison-ivy and the harmless Vir- 
ginia creeper. 

Especial stress has been laid on the diet 
best suited to the growing child. Special 
diets, adapted to illness, have been given. 
Whenever possible, advice that may serve 
as first-aid to the injured has been given 
freely, and so may be said to abound 
throughout the book. 

The Appendix will be found to contain 
a series of diet formulas and instructions 
on the application of poultices, the giving 
of various baths and other treatments re- 
quired in caring for the sick. 

The author acknowledges with pleasure 
the valued assistance and kindness ren- 
dered to him by his publishers, who have 
spared neither time nor expense to aid him 

[xi] 



PREFACE 

in the preparation of this book, which he 
hopes may meet with the same cordial re- 
ception as that accorded to its predecessor, 
The Health-Care of the Baby. 

Louis Fischer. 

New York, 155 West 85th Street. 
September, 1915. 



[xii] 



CONTENTS 

PART I 
GENERAL HYGIENE AND DEVELOPMENT 

CHAPTER PAGE 

I. Channels of Elimination 3 

II. Bathing 6 

III. Ventilation 12 

IV. Sleep 18 

V. Exercise — Amusements 24 

VI. Clothing — How to Haeden a Child .... 36 

VII. School Hygiene — Summer Vacations ... 40 

VIII. Characteristics and Peculiarities of 

Children 47 

IX. Nervous Children 55 

X. Precocious Children 58 

XL The Breath 60 

XII. The Teeth 62 

XIII. Hygiene of the Hair and Scalp 68 

XIV. Growth in Height and Weight 74 

XV. Puberty 75 

XVI. Vaccination 84 

XVII. Temperature — Fever 88 

[ xiii ] 



CONTENTS 

PART II 
NUTRITION 

CHAPTER PAGE 

I. The Diet 97 

Individual requirements — Milk — Quantity 
required — Feeding intervals — Specimen 
diets — Diet for a child from three to 
six years old — Diet for a child with 
weak digestion, from six to ten years 
old — Diet for a child over ten years 
of age — Diet for an underweight child 
— Diet for a very fat child — Diet in 
fever — Diet in diarrhea — Poor appetite 
— Vomiting. 

II. Disoeders Arising From Improper Nutri- 
tion 118 

The bowels — Constipation — Diarrhea — Colic 
or cramps — Intestinal indigestion — Rick- 
ets — Weak ankles — Scurvy. 

PART III 

CATARRHAL, COMMUNICABLE, AND SYS- 
TEMIC DISEASES 

I. Catarrhal Diseases 139 

The throat — Adenoids — Tonsillitis — Rhi- 
nitis, or cold in the head — Coughs. 

II. Communicable Diseases 154 

How contagious diseases are spread — 
Table of communicable diseases — Influ- 
[xiv] 



CONTENTS 

CHAPTER PAGE 

enza — Bronchitis — Bronchial asthma — 
Pneumonia — Tuberculosis — Whooping- 
cough — Mumps — Croup — True membra- 
nous or diphtheritic croup — Diphtheria — 
Chiekenpox — Measles — German measles 
— Scarlet fever — Typhoid fever. 

III. Systemic Diseases 209 

Appendicitis — Malaria — Rheumatism. 

PART IV 

DISEASES OF THE SKIN AND NEKVOUS 
SYSTEM 

I. Diseases of the Skin 221 

Rashes — Insect bites — Eczema — Erysipelas 
Ringworm — Ivy-poison — Sunburn — 
Frost-bite — Hives — Itch — Warts — 
Head-lice— Dandruff. 

II. Diseases or the Nervous System 238 

Defects of speech — Chorea — Habit spasm 
— Convulsions or spasms — Tuberculous 
meningitis — Night-terrors — Paralysis 
— Spinal curvature — Headache. 

PART V 

MISCELLANEOUS DISEASES AND AFFECTIONS 

Miscellaneous Diseases and Affections 263 

Operations in children — Hernia — Enlarged 
glands — Fainting — Cold hands and feet — 



CONTENTS 

PAGE 

Hiccup — Foreign bodies in the ear — Ear- 
ache — Pinkeye — Sties — Trachoma — 
Fever-sores — Injuries — Burns — Splin- 
ters — Sprains — Bleeding — Nosebleed 
— Worms — Tapeworm — Bedwetting 
— Retention of urine — Leucorrhea — Fis- 
sure of the anus — Poisons and antidotes. 

APPENDIX 
Food recipes, 305 — Local remedies, 313 
— Ointments and lotions, 325. 

Index 329 



[xvi] 



LIST OF ILLUSTRATIONS 

Normal and Diseased Throats Frontispiece ' 

Ventilating Window Box Page 16 

Wand Exercises, I Facing 26 " 

Wand Exercises, II Facing 30 ' 

Pulley-weight Exercises, I Between 34 and 35^ 

Pulley-weight Exercises, II Between 34 and 35 '- 

Pulley-weight Exercises, III Facing 36 '^ 

Hanging or Raising Exercise Page 34 

Mat Exercises for Girls Facing 38 

Small-pox Facing 84 " 

Rickets Facing 132 x/ 

Normal Walk. Abnormal Walk Page 134 

A Group of Adenoid Faces Facing 142 V- 

Chicken-pox Facing 194 ^ 

Measles Facing 198 ^ 

Poison Ivy-leaf. Virginia Creeper Facing 230 v 

Ivy Poisoning Facing 230 v 

Spinal Curvature Facing 256 v ' 

Faulty Sitting Positions Between 258 and 259 V 

Correct Sitting Positions Between 258 and 259 ^ 

Enlarged Tuberculous Glands Facing 268 * 

Trachoma Facing 280 

Tapeworm Facing 288 

[ xvii ] 



PART I 

GENERAL HYGIENE AND 
DEVELOPMENT 



i 

; 



[i] 



Chapter I 
CHANNELS OF ELIMINATION 

Theke are four channels through which 
the body is cleansed of impurities. They 
are: first, the skin; second, the bowels; 
third, the kidneys; and fourth, the lungs. 

The skin contains millions of pores The skin 
through which the body throws off impuri- 
ties, but these impurities will only be re- 
moved if the skin is thoroughly cleansed; 
therefore, bathing is imperative for the 
healthy as well as for the sick child. 

Unless one or two movements of the bow- The Bowels 
els takes place daily, illness will result. 

Nature demands that the waste products 
of the system, including foul gases, be 
passed through the body sewer. If this 
sewer is clogged and obstructed the poison 

[3] 



HEALTH-CAKE OF THE GKOWING CHILD 

will remain in the system and give rise to 
various disturbances. 
The Kidneys Next in importance in elimination are the 
kidneys. Every child should be reminded 
to empty its bladder on awakening in the 
morning as well as before retiring at night. 
The bladder should be emptied at least three 
to four times a day. Nature demands more 
frequent relief if large quantities of liquids 
are taken. A child should pass at least one 
quart of urine in twenty-four hours. 

With the urine is passed excessive poisons 
thrown off by the blood and glands, through 
the kidneys. If these poisons are retained 
they can give rise to disease. 

If the quantity of urine is scant and the 
child passes but an ounce or two at a time 
then ten drops of niter may be given in a 
little water, every hour for three doses. If 
the kidneys do not respond promptly it in- 
dicates sluggishness or perhaps congestion 

[4] 



CHANNELS OF ELIMINATION 

of the kidneys, which must be supervised 
by a physician. 

When fresh air is taken into the lungs The Lungs 
we give the body a lung tonic. The foul air 
passed by each expiration rids the body of 
poisons collected within the lungs. 



[5] 



Chapter II 
BATHING 

The Tepid For the healthy child a daily tub bath 

Tub Bath . - 

should be given in the morning, at a tem- 
perature of from 95 to 98 degrees. It is 
more beneficial to gradually lower the tem- 
perature of the bath two degrees daily un- 
til from 80 to 85 degrees is reached. This 
cooling of the water has a very toning ef- 
fect on the nervous system, which is espe- 
cially indicated in the nervous and restless 
child. In many cases it is better, imme- 
coid shower diately after the bath, to let a shower of 
cold water run over the neck and shoulders 
for a few minutes. This will not only con- 
tract the pores and prevent the taking of 
cold but it is one of the best tonics for the 
nerve terminals. 

[6] 



BATHING 

Wlien a child is susceptible to colds and 
coughs, and especially if the weather is cold 
and damp and raw in winter, the tub bath 
should be given in the evening rather than 
in the morning. To such children the tub 
bath should be given first, then the supper, 
before retiring. 

The reaction following a cold bath should Reaction 
be a ruddy appearance of the skin and a gen- 
eral glow, proving that the circulation has 
returned to the surface with renewed vigor. 
If however after the cold bath the skin 
does not become pink and the fingers and 
toes remain blue and cold it proves an in- 
complete reaction. The effects of such cold 
baths are harmful. 

When after a cold bath children shiver 
and complain of the cold and do not feel 
braced up but are tired and languid, it 
shows that to them cold baths are depress- 
ing and harmful. We should not persist 

[7] 



HEALTH-CARE OF THE GROWING CHILD 



Duration of 
Bath 



Warm Bath 



with the cold baths, but instead give them 
tepid or warm. 

A cool or cold bath for a child of from 
two to five years should never be given 
longer than two minutes, to a child of from 
five to ten years not longer than three 
minutes. Frail, sensitive, and thin children 
are susceptible to the influence of cold air 
and water, hence we should watch the body 
and note the color of the skin during the 
bath. If blueness or extreme paleness takes 
place, it shows that the bath should be 
stopped and followed by a brisk rubbing 
with a coarse bath towel. Exhaustion and 
weakness will follow in an enfeebled child 
if the bath is prolonged beyond the toler- 
ance of the body. A bath properly given 
stimulates, a bath prolonged, depresses. 

A warm bath should never be prolonged 
more than five to six minutes. The tem- 
perature of the water should be from 100 

[8] 



BATHING 

to 103 degrees. After briskly rubbing the 
skin dry, it is a good plan to rub with alco- 
hol. This alcoholic sponging closes the 
pores and prevents perspiration, which oth- 
erwise might result in chilling the body. 

Most children bathe too long in the surf. An ocean Bath 
There is no objection to giving a child an 
hour or several hours of activity and play 
on the shore, but the bath itself should never 
be prolonged more than ten to fifteen 
minutes and should then be followed by 
brisk rubbing. Friction after the bath to 
restore circulation is as important as the 
salt bath, and gives the reaction to the cir- 
culation. 

No child of fourteen or under should be too Frequent 

Bathing 

permitted to bathe more than once a day. 
Too frequent bathing is harmful and low- 
ers the vitality of the system. 

The good effect of living at the seashore 
is frequently counteracted by too much bath- 

[9] 






HEALTH-CAKE OF THE GKOWING CHILD 



Wading or 
Paddling 



Bath for 
Sleeplessness 



ing, which instead of toning the system de- 
presses the nervous system. 

Wading or paddling in the sea does no 
harm if not carried to extreme, but it may 
do great harm if the heat of the sun beats 
upon the head while the feet and legs are 
in an extremely cold temperature. Fre- 
quently prolonged wading will result in in- 
testinal catarrh and in a disturbance of the 
nervous system. 

The warm bath at a temperature of from 
103 to 105 degrees, if used from three to 
five minutes, with plenty of friction while 
in the tub, will soothe the nervous system 
and quiet the child. It promotes sleep. 

When children are restless and their di- 
gestion is not disturbed, especially if they 
have been very active at school — then a 
very warm bath will soothe the nerves and 
quiet the brain, thus promoting sleep. 

In order that the skin performs the func- 

[10] 



BATHING 

tion of eliminating waste material from the 
body it is of the utmost importance that it 
be kept in as perfect a condition of health 
as possible. The circulation must be main- 
tained by sufficient clothing, and the waste 
products of the sweat glands constantly 
thrown out through millions of glands in 
the skin must be removed by frequent bath- 
ing and friction. 



[ii] 



Chapter III 

VENTILATION 

The blood contains oxygen, and the color- 
ing matter of the blood depends on its sup- 
ply of oxygen; hence, pure air is a neces- 
sary factor in the nutrition of the body, and 
especially necessary for the building of 
healthy red blood corpuscles. 
Dangers of If therefore a child is permitted to 

Foul Air 

breathe foul air or air robbed of its oxygen, 
the result will be speedily shown by the 
color of the skin. Such a child, instead of 
having a healthy, ruddy color, has a pale, 
sallow color, due to the lack of oxygen. 
When it is remembered that an ordinary 
gas-jet consumes as much oxygen as five 
people, then we can understand why it is 
imperative to open windows and admit pure 
air if gas-jets have been burning. 

[12] 



VENTILATION 

There are other means of polluting air in 
the house in addition to the burning of gas. 
These are: gas given off from defective 
stoves or furnaces, cellars that are damp, 
house filth, exhalations from the body, and 
decomposing vegetable matter. 

What effect has breathing of foul air on 
the child ! Such a child is usually very sus- 
ceptible to colds and coughs. These are the 
children that have a lowered vitality, and 
the bodily resistance being reduced they 
invite catarrh of the head and bronchial 
tubes; they also are susceptible to pneu- 
monia and tuberculosis. After a winter of 
poor ventilation such children usually de- 
velop adenoid vegetations and enlarged ton- 
sils. They are restless by day, very sensi- 
tive and nervous, and do not sleep well. As 
a result of the loss of sleep, the appetite is 
impaired. The bowels do not functionate 
properly. Such children are underweight 

[13] 



HEALTH-CAKE OF THE GEOWING CHILD 

and show the evidences of malnutrition. 
They are subnormal, and as a result of this 
general weakness are more susceptible to 
scarlet fever and diphtheria than they would 
be in health. 

Fresh food is to the stomach what fresh 
air is to the lungs. Plants absorb oxygen 
from the air and thrive. The same applies 
to the lungs, which take in the oxygen and 
oxygenate the blood, thus distributing 
healthy blood corpuscles through the vital 
organs of the body, also through the blood 
vessels which enter the skin, nerves, and 
the large organs of the body. The stom- 
ach, the liver, and the intestines are the vital 
organs of digestion, and if they carry thin 
blood or blood that is not up to the stand- 
ard in strength, they cannot perform their 
proper functions and we find sluggish ac- 
tions resulting therefrom. It is useless to 
have a child out of doors all day playing in 

[14] 



VENTILATION 

and breathing fresh air, and then have him 
cooped up at night in a stuffy bedroom with 
windows and doors closed, and heavily 
blanketed. "What is gained during the day 
by an outdoor life is lost re-breathing foul 
or impure air at night. Night air is purer value of 

Night Air 

than day air, and the windows should re- 
main open, with full and free ventilation, 
because the lungs give off poisoned air con- 
tinuously. 

I do not advocate placing children in 
draughts, but they should be given the bene- 
fit of plenty of fresh air with windows open, 
as thereby they will sleep better. Every 
mother or nurse knows that when an infant 
is taken into the street, especially in winter, 
it invariably goes to sleep, and the moment 
such infant is brought back into the heated 
house it awakens, is restless and dissatisfied 
until it is again taken out-of-doors. 

When draughts are feared, or the wind 

[15] 



HEALTH-CARE OF THE GROWING CHILD 

blows too strongly, a simple contrivance 
consists in having a window-board inserted 




=-=,-« 



OUTSIDE VIEW. 



T tt T t' il 'T T r T r 









INSIDE VIEW. 

Fig. 1. 
DAYBROOK VENTILATOR WINDOW BOX. 

These ventilators can be bought at department 
stores. A fine bronze wire screen built into the venti- 
lator prevents dust, snow, and insects from entering. 
Sliding extensions make it adjustable to any window. 

Ventilator Adjusted, inside view. Air is admitted 
from the outside, and reflected at right angles, enter- 
ing the room through the top of the ventilator, where 
movable slides control the amount of air admitted. 

after raising the window (Fig. 1). Such 
window-boards allow the entrance of suf- 
ficient air without causing a draught. 

[16] 



VENTILATION 

The value of sunlight for the growth of sunlight 
plants is too well known to be dwelt upon. 
Sunlight destroys bacteria. Disease germs 
die when exposed to sunlight. The rays of 
the sun in a room occupied by a typhoid, 
diphtheria, or tuberculosis patient will de- 
stroy more germs and in less time than the 
commonly used disinfectants. It is a strong 
argument in favor of opening windows, ad- 
mitting sunshine, and giving the bedclo thing 
as well as the room a sun bath. 

In many sanitaria in this country and 
abroad patients afflicted with tuberculosis 
are exposed to the sun's rays. The only 
covering on the body is a white sheet. This 
is called "heliotherapy," and hardens the 
skin; besides, the sun's rays penetrate into 
the deeper parts of the lung and thereby 
destroy the active germ life which causes 
lung disease. 



[17] 



Chapter IV 

SLEEP 

An active child walking or running about 
needs rest. During sleep the body restores 
its wasted energy. The nervous energy 
causes great destruction of the nerve-tissue, 
in which the brain, the muscles, and all the 
vital organs of the child's machine partici- 
pate. 

Sleep is nature 's method of repair to the 
vital organs. It is like an electric current 
which recharges the batteries of the system 
exhausted by the wear and tear incident to 
an active life. 
Amount of A weak, nervous, and frail child requires 

Sleep Required 

more rest, and a midday rest of one-half 
hour after lunch. A strong and robust child 

[18] 



SLEEP 

may do without the midday rest. Children 
under six years should rest at least eleven 
to twelve hours. A growing child should 
not be compared to an adult. A growing 
child needs proportionately more sleep. A 
child of from twelve to fifteen years re- 
quires from nine to ten hours' sleep. At 
this critical period we should insist on chil- 
dren retiring between 8 and 9 P.M., and 
rest, even if they do not sleep, until 6.30 in 
the morning. 

When children are deprived of sleep or 
do not have a sound sleep their digestion 
will be impaired, so that loss of appetite, 
constipation, and indigestion may result. 
Irritability and restlessness by day, dulness 
in school, and backwardness in both physical 
and mental development will result from 
insufficient sleep. 

From the loss of sleep and appetite the 
body will lose weight. It is surprizing to 

[19] 



HEALTH-CAEE OF THE GKOWING CHILD 

note the bodily gain when sufficient sleep 
is given a child. 
to Promote To promote sleep the bedroom should be 

Sleep r 

cool and well ventilated; this will give a 
continuous supply of fresh air. The cloth- 
ing should be loose, to permit freedom of 
respiration. The bedclothing should be 
loose and light, and the child's arms and legs 
free. Straight- jacket methods should be 
discarded. 

Sufficient food should be given at the eve- 
ning meal, but the stomach should not be 
overloaded. If too much food is given, in- 
digestion, colic and cramps in the stomach 
will interfere with sleep. 

No child should go to bed at night with- 
out having had a movement of the bowels 
during the day. If constipation exists, na- 
ture should be assisted by giving an injec- 
tion of one pint of Castile soap water. (See 
treatment of constipation.) 

[20] 



SLEEP 

Exciting stories which frighten the child 
and frequently cause dreams should not be 
told before retiring. Pleasant, quiet amuse- 
ments and games will aid in promoting 
sleep. 

There are many conditions which disturb 
sleep, causing insomnia, and if sleepless- 
ness continues persistently a physician 
should be consulted. 

The eating of too much candy may cause 
worms which will irritate the child. Indi- 
gestion, colic, earache, toothache, adenoids, 
or enlarged tonsils which prevent proper 
breathing are frequent causes of restless 
sleep. If a cough is present which disturbs 
sleep then we should suspect whooping- 
cough or adenoids. Masturbation in wake- 
ful children should be suspected and 
watched for; this applies to girls as well 
as to boys. To safeguard the child where 
such suspicion exists we should insist on 

[21] 



HEALTH-CAKE OF THE GKOWING CHILD 

having the child sleep with its hands out- 
side of the blankets. 
The Necessity Concerning the necessity for sleep, Dr. 

for Sleep 

Hammond in one of his articles on l ' Sleep ' ' 
says: "So long as an individual is awake, 
there is not a single second of his life dur- 
ing which his brain is altogether inactive. 
... Its substance is consumed by every 
thought, by every action of the will, by 
every sound that is heard, by every object 
that is seen, by every substance that is 
touched, by every odor that is smelled, by 
every painful or pleasurable sensation; and 
so each instinct of our lives witnesses the 
decay of some portion of its mass and the 
formation of a new material to take its 
place. . . . The necessity for sleep is due 
to the fact that during our waking moments 
the formation of the new substance does 
not go on as rapidly as the decay of the 
old. The state of comparative repose which 

[22] 



SLEEP 

attends upon this condition allows the bal- 
ance to be restored, and hence the feeling 
of freshness and rejuvenation we experi- 
ence after a sound and healthy sleep/ ' 



[23] 



Chapter V 

EXERCISE— AMUSEMENTS 

Every child requires exercise. A child 
will run, and jump, and shout. The jump- 
ing and shouting strengthens the lungs and 
voice. It also develops the chest, stimulates 
the appetite, and aids digestion. The run- 
ning stimulates the circulation of the blood, 
and from this active perspiration will result. 
Perspiration is healthful; it is the means 
of removing waste products through the 
pores of the skin. The lungs also will throw 
off exhalations by taking in a greater supply 
of oxygen. This strengthens the blood and 
renders the brain more active. 
Lung Children on awaking should be taught 

Gymnastics 

to take deep breaths. They should inhale 
and exhale very slowly. This form of lung 

[24] 



EXEKCISE— AMUSEMENTS 

exercise will strengthen the chest-walls 
and if continued for weeks, months, and 
years will prevent flat-chested and pigeon- 
breasted conditions in the growing child. 
Breathing should be through the nose, the 
mouth remaining closed. If there is any 
obstruction in the nose and throat such as 
is caused by enlarged tonsils or adenoids, 
the same should be removed. Thorough 
oxygenation of the lungs is very necessary. 
It is nature's method of giving fresh lung- 
food. 

All exercises and games such as ball- 
playing, walking, running, bar-exercise, and 
football have their advantages and should 
be encouraged. For a poorly developed 
chest nothing can equal rowing. This ex- 
ercises not only the muscles of the arms 
and chest and back but also strengthens the 
lower limbs. 

For girls the hoop, roller-skates, bean- 

[25] 



HEALTH-CARE OF THE GROWING CHILD 

bag, skipping-rope, tennis, and rowing are 
among the games which may be permitted. 
Swimming for both boys and girls is one of 
the best exercises. 

over Exercise No games or exercises should be permit- 
ted during the menstrual period. Children 
have a tendency to overtax their strength 
by too much exercise. Serious results may 
follow if the heart is overstrained, and it 
is the duty of every mother or nurse to be 
sure that the child's heart is able to stand 
the amount of exercise taken. While lack 
of exercise will render the muscles soft and 
flabby, so will too much exercise overstrain 
and cause, in some instances, irreparable 
damage. 

proper During the period of growth the bones 

are soft and yield readily, and this is the 
time when tight-fitting clothing will inter- 
fere with the proper expansion of the 
chest. Continued pressure on the chest by 

[26] 




Fig. 2. Position. — Wand held in both hands and rest- 
ing against the front of the thighs, palms turned 
backward. 

Fig. 3. Position. — Wand forward upward, swing, 
arms straight and vertical. Wand downward, swing. 

Fig. 4. Position. — Step-out, right. Swing wand to 
right horizontal. Step-out, left. Swing wand to left 
horizontal. Step-out, right. Swing wand to right 
vertical. Step-out, left. Swing wand to left vertical. 




EALTJ 
b« 

Over Exercise be pemiit- 

trual period. Children 

overtax their strength 

Serio mlts may 

I it 

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Of gT(< 

elotlr 
sure on i: 



EXEKCISE— AMUSEMENTS 

faulty clothing may result in deformity such 
as a flat chest. Most public schools and 
kindergartens give callisthenics after a 
short period of study and this is one of the 
best means of restoring the circulation of 
the blood after a period of brain activity. 
During rainy weather exercise should be 
given indoors. 

The child should be encouraged to sleep 
with the windows wide open. If after study- 
ing or confinement in a room the child's 
hands or feet are cold, the use of pulley- 
weights or light dumb-bells, or a game of 
handball for from five to ten minutes will 
quickly restore the circulation of the blood. 

Walking briskly is one of the best means 
of aiding the circulation. In modern houses 
the use of elevators has deprived children 
of one of the best means of exercise for the 
extremities, also for the heart, namely, 
stair-climbing. 

[27] 



HEALTH-CAEE OF THE GROWING CHILD 

wand Exercise Exercise with a wand is practised in 
many schools. When children do not attend 
school this form of exercise can be carried 
out at home. 

The wand is usually of wood, from 24 to 
30 inches in length and from one-half to 
an inch in diameter. The ends should be 
rounded. These sticks can be purchased 
from dealers in gymnasium supplies or 
from furniture manufacturers. As a sub- 
stitute a walking cane or the handle of a 
broom may be used. 

This form of exercise, like dumb-bells, is 
especially adapted for the development of 
the arms. In order to properly distribute 
the work, these exercises, in combination 
with chest-, abdomen-, and leg-exercises, 
distribute the movements. 

The inserted illustrations give an idea 
of the movements possible with the wand. 
The exercises should be continued ten to 

[28] 



EXERCISE— AMUSEMENTS 

twenty minutes, but never to the point of 
fatigue. Gymnastics, twice daily from five 
to ten minutes, will aid in the development 
of the bones and muscles of the body. A 
graceful carriage will be acquired if the 
muscles have tone. 

The early use of gymnastic exercises will 
prevent many of the deformities of the 
chest and spine arising from flabby, unused 
muscles. 

Deep breathing — lung-expansion — is the 
best means of oxygenating the lungs. By 
this means we strengthen and prevent 
disease-germs from taking hold. 

PULLEY-WEIGHT OR CHEST- 
WEIGHT EXERCISES 

Pulley-weight exercises are adapted for 
the home. They are especially useful for 
indoor exercise during inclement weather. 

These exercises should be given with one 

[29] 



HEALTH-CAKE OF THE GROWING CHILD 

hand only, later after these simple move- 
ments are mastered both hands can be used. 
My preference however is for the use of 
the gymnasium at school or otherwise under 
the supervision of one competent to instruct 
in the development of the muscles of the 
body. 

BEGINNER'S SERIES (WITH ONE HAND) 

Right Side to Machine — I. Position — Broad 
base (feet straight forward, the weight on the 
outer borders), left hand on the hip, right, the 
arm out. 

1st Count — Swing right arm down, poise left. 
(Fig. 8.) 

2d Count — Bend right arm, elbow up, poise 
right. (Fig. 9.) 

Progression — (a) 1st Count — Swing right arm 
down, bending trunk forward (trunk relaxed, 
knees straight). (Fig. 10.) 

2d Count — As in I, count 2. (Fig. 9.) 

Progression — (6) Position — Feet together. 

1st Count — Swing the right arm down, change 
to left. (Fig. 11.) 

2d Count — As in I, count 2. (Fig. 9.) 

[30] 




/ 



Fig. 5. Position.— Drop to left knee. Wand aimed 
forward along left arm. ^ A 

Position. — Drop to right knee. Wand aimed forward 
along- right arm. s. 

Fig. 6. Position.— Wand overhead, as in No. 2 



arms, drop back of head. 
to left. Step-out, right, 
forward on chest. 



Bend 

Step-out, left. Bend body- 
Bend body to right. Bring 



Fig. 7. Position. — Retain position as in Fig. 5. Step- 
out, right. Cross right arm over left. Step-out, left. 
Cross left arm over right. 





GROT fLD 

hand < 

ool or 
tbt competent to instruct 

it of the muscles of the 

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xed, 

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>n— Feet together, 
right arm down, change 

KM 






EXEKCISE— AMUSEMENTS 

Facing Machine — II. Position — Left foot 
forward, right hand on hip, left arm forward, 
palm np. 

1st Count — Swing left arm down, poise for- 
ward. (Fig. 12.) (This forward poise is al- 
ways taken with the chest high, the neck forced 
back, and no hollow in the back.) 

2d Count — Bend arm, elbow down and in, 
poise forward. (Fig. 13.) 

Progression — (a) 1st Count — As in II, 
count 1. 

2d Count — Swing arm out, shoulder high, 
poise forward. (Fig. 15.) 

Progression — (c) 1st Count — Swing left arm 
down, bend trunk forward (bowing position). 
(Fig. 14.) 

2d Count — Bend arm forward, elbow out, 
poise forward. 

3d Count — Repeat 1st count. 

4th Count — Swing left arm out, poise for- 
ward. (Fig. 15.) 

III. Position — Broad back, right hand on 
hip, left arm forward. 

1st Count — Swing left hand down to right 
ankle, bend and twist trunk right. 

2d Count — Swing left arm out, twist trunk 
left (chest forward, weight over left foot). 

[31] 



HEALTH-CAKE OF THE GKOWING CHILD 

MAT EXERCISES FOR GIRLS 

To strengthen the circulation of the blood 
and give tone to the muscles, the following 
series of exercises are advantageous. They 
should be used in the morning, preferably 
before breakfast. From five to ten min- 
utes will suffice. A tub-bath or shower- 
bath, followed by a brisk rubbing, after the 
exercises will prepare any girl for her day's 
work. These exercises should be omitted 
during the menstrual period. 

Figs. 16 and 17 

Position — (1) On the back, the legs stretched 
down. 

Exercise — (1) Bend the knee up toward the 
chest, then stretch the leg down to position and 
relax it. 

Take the movement six times with each leg. 

(2) Bend the knee up as before. From this 
bent-knee position stretch the leg up, making a 
straight line to the tip of the toes. 

(3) Bend the knee again. 

(4) Stretch the leg back to position on the 
floor. Do this six times with each leg. 

[32] 



EXEECISE— AMUSEMENTS 

Fig. 18 

Position — (2) On the back, with legs 
stretched down. 

(1) Raise the arms straight in front of the 
body and over the head until they touch the 
floor. Reach up with the finger tips, stretching 
comfortably. Then carry the arms back to the 
sides again. Do this six times. 

(2) Take the same exercise, drawing in a full 
breath as the arms are raised and letting it out 
as the arms are returned to the sides. 

At another time, instead of carrying the arms 
forward overhead, vary the foregoing exercise 
by moving them sideways through half a circle 
on the floor to the same position back of the 
head, taking a deep breath as the arms move 
toward the head, and letting it out as the arms 
come back to the sides. 

Fig. 19 

Position — (3) On the back with knees drawn 
up, the soles of the feet on the floor. 

Exercise — From this position raise the hips 
until there is a straight incline from the neck to 
knees. Do not hold the position and relax thor- 
oughly before repeating. Take this exercise 
three to six times, limiting it to three times for 
a few weeks. r33 . 



HEALTH-CAKE OF THE GKOWING CHILD 

Fig. 20 

For a child from five to twelve years old, 
hanging on a bar and heaving or raising the body 




from the floor six to eight times will strengthen 
the muscles of the back and chest. It is val- 

[34] 




a: 

a 

02 

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o 
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-1-3 

60 



O 
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EXEKCISE— AMUSEMENTS 

liable to aid in the expansion and development 
of the lungs, and will also aid in correcting 
round shoulders. 

The correction of deformities such as spinal 
curvatures cannot be carried out in the home 
but must be done under the supervision of a 
physician or one skilled in physical culture. 



[35] 



Chapter VI 

CLOTHING— HOW TO HARDEN A 
CHILD 

It is surprizing to see how differently 
mothers dress their children. A few facts 
must be borne in mind before deciding this 
important factor. The pulse of a child is 
very much faster than that of an adult, 
therefore the circulation of its blood in the 
skin is more active. The surface of the 
body of a healthy child is warmer than that 
of an adult, because of the greater activity 
of the healthy growing child. Too much 
clothing, therefore, will cause an overheat- 
ing of the skin, and perspiration followed 
by chilliness results. 
Effect of In addition to overheating the skin by 

Excessive 

ciothmg an excess j ve quantity of clothing, we render 

[36] 




CD 

M 

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bJD 



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f-l 
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CLOTHING— HOW TO HAKDEN A CHILD 

the child more susceptible to catarrhal af- 
fections. Many children have been brought 
to me in midsummer wearing the thickest 
of woolens. Such children are constant suf- 
ferers of either catarrhal affections of the 
respiratory passages or they suffer with 
catarrh of the bowels. If an anxious mother 
overheats the skin with heavy clothing by 
day, she will be apt to overblanket the 
child at night. A child so treated invari- 
ably suffers with colds as well as restless 
nights. 

It is surprizing to see how much good can 
be accomplished by resorting to a radical 
change. Give a tepid or cool bath in the 
morning, reduce the weight of the under- 
clothing both winter and summer, give less 
blanketing, and a cool room with fresh air 
at night. Such a radical change will fre- 
quently cause a restless and nervous child 
to be transformed in a few weeks or months 

[37] 



HEALTH-CAKE OF THE GKOWING CHILD 



Hardening 



Open-air 

Classes 



into a healthier, stronger, and less irritable 
child. 

By hardening a child we render it less 
susceptible to disease. Before resorting to 
extreme measures of hardening we should 
have the child examined by a physician. 
Frail children or subnormal children re- 
quire toning with iron, hypophosphates or 
other tonics before attempting the hygienic 
changes suggested. 

The value of fresh air as a means of 
bracing up anemic and pale children is so 
well recognized in New York and elsewhere 
in the United States that the public schools 
have established open-air classes during the 
winter term. In these classes, usually on 
the roofs of school-buildings, the children 
are dressed in warm clothing, many of them 
wearing heavy sweaters and caps. In this 
manner they receive instruction in the open 
air. 

[38] 




Mat Exercises 



CLOTHING— HOW TO HAKDEN A CHILD 

For the frail child with a poor appetite, 
for one having enlarged glands, for the 
restless and nervous child, for the weak and 
puny child, and for the one that inherits a 
tuberculous tendency, the open-air classes 
are indicated, and prove beneficial. The 
child in the open air eats more, digests bet- 
ter, and consequently assimilates his food, 
thus enriching the blood, adding strength 
to the body and offering resistance to dis- 
ease. Such children do not sniffle and take 
cold as easily as children brought up in 
warmer surroundings. There are, however, 
exceptions to this rule. 



[39] 



Chapter VII 

SCHOOL HYGIENE— SUMMER 
VACATIONS 

Theke are two places in a child's life 
which play an important part in its mental 
and physical development; they are the 
home and the school. Many parents have 
told me that their child is wilful, disobedi- 
ent, and is only impressed by the teacher 
at school. Thus parents frequently go to 
school to secure the active cooperation of 
the teacher, to impress the dangers of faulty 
habits, to correct faults acquired by imita- 
tion of other pupils, and to aid in procuring 
home discipline. 

Teachers frequently ask the mother to 
assist in correcting little vices and habits 
which apparently are unnoticed in the home. 

[40] 



SCHOOL HYGIENE— SUMMER VACATIONS 

It is wrong to expect the child to be a per- 
fect specimen of childhood if the home train- 
ing is lacking and if the mental, hygienic, 
and moral training given at school is not 
supplemented by the parents in the home. 

What can we expect of a child who sees 
discipline at school, good breeding, educa- 
tion, refinement, and plenty of fresh air, 
and then comes home to find a disorganized, 
insanitary, and ill-ventilated home, just the 
reverse of what the child saw at school. 
After a few years the child will recognize 
the difference and will antagonize its own 
parents. 

Modern hygiene has been so thoroughly 
instilled into the minds of teachers in both 
public and private schools that I venture to 
say, with few exceptions, the ventilation 
and sanitary environment is as good and 
better in most schools than it is in the aver- 
age home. 

[41] 



Schools 



HEALTH-CAKE OF THE GKOWING CHILD 

I know of instances where mothers told 

me they were glad to send their children 

to school because they were not capable of 

training them at home. 

Dormitories In order to economize space, boarding- 

and Boarding- 
SChOOlS frequently use folding-beds. I have 

known of one case of suffocation where the 

bed suddenly closed itself on the sleeper. 

Folding-beds are insanitary, as they sel- 
dom receive the requisite amount of sun 
and air. They are therefore hotbeds for 
disease-germs. 

Ventilation is of the utmost importance, 
and a continuous supply of oxygen is as 
necessary at night as by day, to secure 
proper ventilation. 

When children sleep in dormitories, we 
should try to arrange for single rooms, if 
possible. The supervision of boys and girls 
at boarding-schools is a very important fac- 
tor, and we should be very careful to know 

[42] 



SCHOOL HYGIENE— SUMMEE VACATIONS 

the character of the other scholars lest bad 
habits are transmitted which may under- 
mine the moral and physical welfare of our 
child's future. 
Every mother should train her child to Nature's 

Demands 

have the bowels move, if possible, each s2SS at 
morning, or soon after a meal. By thus 
training the bowels the habit of regularity 
will soon be established. Many cases of 
constipation owe their origin to poor train- 
ing. On the other hand, the food may have 
a distinct constipating effect, and then noth- 
ing but a change in diet is necessary. 

If the child feels a demand of nature, per- 
mission should be given the child by the 
teacher to answer this call. When such de- 
sire of nature is repeatedly unanswered, a 
tendency toward stool-stagnation is formed. 
There is too much discipline enforced and 
too little relaxing of rules, when necessary, 
at school. I am constantly compelled to 

[43] 



HEALTH-CARE OF THE GROWING CHILD 

write letters to both principals and teachers 

of schools, asking them to grant permission 

to this or that child to satisfy the calls of 

nature. 

Summer Vacations 

In deciding where to send a child for a 
decided change of air we must consider 
what portion of the human system requires 
development. 

A healthy boy or girl, well developed and 
with fair appetite, may be sent either to the 
seashore or the mountains. At both places 
there is ample opportunity for exercise, 
recreation, and change of scene. 

If the child has been diligent at school, 
camp-life would be an ideal change. Tent- 
life in the mountains with a plentiful sup- 
ply of balsam and pine trees, long walks 
through the woods, rowing and swimming 
in the lake is sufficient tonic for a hard 
worked brain and nervous system. 

[44] 



SCHOOL HYGIENE— SUMMEK VACATIONS 
Children having a tendency to catarrh in catarrhal 

° Tendencies 

the head, who suffer or have suffered with 
adenoid vegetations and enlarged tonsils 
will do best in the mountains. Mountain 
air has a tendency to dry catarrhal secre- 
tions, besides hardening the child suffi- 
ciently to lessen susceptibility to colds. 

Children suffering with winter colds, as 
influenza, bronchitis, or pneumonia, require 
toning-up of their air-passages for which 
nothing is better than an altitude of from 
1,000 to 2,000 feet. 

Children suffering with stomach or bowel Dyspeptic 

or Intestinal 

affections, especially a tendency to loose Affectlons 
bowels, will be strengthened by going to the 
seashore. Cold bathing need not be indulged 
in. Be sting on the beach will strengthen 
the stomach and tone the bowels. Fre- 
quently a change from the city to the sea- 
shore, in a long-standing case of loose bow- 
els, will terminate favorably in a few days. 

[45] 



HEALTH-CAKE OF THE GKOWING CHILD 



Nervous and 
Convalescent 
Children 



Anaemic 
Children 



Very nervous, sensitive children, and 
those suffering with insomnia require rest. 
They should have little or no excitement. 
A quiet sojourn in the mountains is most 
beneficial. The altitude should not be 
higher than twelve hundred feet. 

Convalescent children after long-stand- 
ing illness require a quiet restful climate of 
either the mountains or the farm. 

Children with tendency to nose-bleed 
should not be sent to high altitudes. 

Anaemic children, especially girls around 
the age of puberty, will do better in the 
mountains, especially in a camp. Camp 
routine will harden and develop them. I 
have seen frail, nervous and sensitive chil- 
dren transformed by a summer in camp. 
They were able to continue out-dopr activi- 
ties during the winter with marked benefit 
in development; especially was this benefit 
shown in the nervous system. 

[46] 



Chapter VIII 

CHARACTERISTICS AND PECULIARI- 
TIES OF CHILDREN 

Just as an adult craves quiet, rest, and 
peaceful surroundings, so does a child de- 
sire the very opposite — noise, running, 
jumping, and perpetual motion. While this 
may he looked upon hy some as a peculiarity 
in childhood, it is a normal characteristic. 
This important factor must be borne in mind 
in selecting a nursemaid. If the nurse is 
at all sensitive or nervous, and complains 
of the child's overactivity, then she is not 
a fit companion for the child. Children's 
muscles are like rubber, and from the con- 
stant use of these muscles they should sleep 
very soundly, due to the exhaustion of the 
daily exercise. 

[47] 



HEALTH-CAKE OF THE GKOWING CHILD 

Fear Fear exists in all children, and can be 

removed or greatly lessened by reasoning. 
Find out what the child fears, and try to 
eliminate such fear by proving the absurd- 
ity of the same. 

Children should not be frightened with 
stories or pictures. I have known of many 
cases where fright produced a nervous dis- 
order. St. Vitus 's dance is a common re- 
sult of a fright and very difficult to remedy 
in a frail, sensitive child. 

imitation Children are great students ; not only do 

they watch every move and expression, but 
they also possess the faculty of imitation 
to a marked degree. They will mimic and 
lisp and they will make grimaces of all 
kinds, but they will also mimic facial 
twitching, until the same remains as a per- 
manent habit. 

Many mothers will recall children who be- 
gan to twitch the mouth or eye muscles be- 

[48] 



PECULIAKITIES OF CHILDEEN 

cause some other child at school did the 
same. It looked cute ; later on this imita- 
tion grew to be a habit which remained 
many years. 

The brain of a growing child possesses 
quantity but lacks quality; it is an unde- 
veloped organ. It is like a blank record of 
a phonograph — sensitive; it receives and 
gives off impressions. Curiosity is natural curiosity 
to childhood. It is natural because it is the 
child 's method of learning. It receives im- 
pressions and sees things which its brain 
cannot comprehend. 

Instinct compels the child to ask why is 
this and why is that. Childhood demands 
an explanation of everything that it sees and 
hears in the universe. It is the privilege of 
children to be instructed and enlightened. 

A crude brain can be developed provided Environment 
the environment is intellectual. To associ- 
ate a child with an ignorant nurse or with a 

[49] 



HEALTH-CAKE OF THE GKOWING CHILD 

woman lacking good breeding and education 
is detrimental to the child. The seeds of 
wisdom can only be sown into the fertile 
brain of a child in an intellectual atmos- 
phere. On the other hand, many years are 
wasted, and we may have to undo the dam- 
age done by an incompetent maid in whose 
care the child had been placed. For this 
reason we should be extremely careful in 
selecting the companion for a child, lest we 
do harm rather than good. The education 
received in childhood is like a foundation 
for a house : if it is well built, it remains ; 
if poorly constructed, we shall have sooner 
or later a tottering structure. 
Rewards Eewards should be given much more fre- 

quently than punishments. Children like 
noise, and the more noise the better. It is 
impossible to keep some children quiet. Re- 
ward a child if he has been quiet for a cer- 
tain time by permitting him to let off steam 

[50] 



PECULIAKITIES OF CHILDREN 

and become noisy and active. We should 
not reward a child by giving him praise, 
but there are times when a word of encour- 
agement after a difficult task is in order. 
Likewise, if a child acquire a bad habit, 
and we notice a desire to correct such habit, 
a word of encouragement is then in order. 

The management of children will bring Punishment 
out their good or their bad qualities. It 
depends on the mother or nurse as to 
whether the child obeys or disobeys. This 
can readily be noticed at school. The same 
class under the management of two teachers 
behaves differently. With one teacher there 
is obedience, order, and the children learn 
a great deal, while another teacher cannot 
enforce discipline, and will complain that 
she has a very bad class ; therefore, the bad 
and the good can be brought out, according 
to the way children are managed. 

Children need activity, and it is our duty 

[51] 



HEALTH-CAKE OF THE GKOWING CHILD 

to keep them interested and give them some- 
thing to do, otherwise they will get into 
mischief. 

All children can not he punished alike. 
Punishment must he meted out according 
to their physical strength. A strong child 
should be deprived of his most favorite 
game. Most boys are passionately fond of 
a game of ball. Forbidding this game for 
a certain number of hours or days will, in 
most cases, be all that is required. 

A highly strung and nervous child can 
best be punished by putting him to bed. 
This serves the double purpose of resting 
the nervous system in addition to correct- 
ing some disobedience. 

Always punish a child soon after the of- 
fense, and explain to him why he is being 
punished or corrected. After the punish- 
ment is over, do not refer to the offense or 
the punishment. 

[52] 



PECULIAEITIES OF CHILDEEN 
Corporal punishment should not be ad- corporal 

Punishment 

ministered to children. I invariably advise 
every mother in selecting a nursemaid to 
forbid bodily punishment. If a nursemaid 
is given permission to slap or otherwise 
punish a child in her care, while she may 
exercise good judgment, she may also be 
guilty of very poor judgment and apply 
corporal punishment for offenses which may 
be due to illness. I have known sensitive 
children who were punished for refusing to 
eat, when later it was discovered the child 
had a sore throat or symptoms of tonsillitis, 
which caused pain on swallowing. 

Good judgment must prevail in deciding Despondency 
whether or no the child's offense is really 
serious enough to deserve corporal punish- 
ment. If children are too severely punished 
they become despondent, and in rare in- 
stances have committed suicide. 

There is a vast difference between wrong- 

[53] 



HEALTH-CAKE OF THE GKOWING CHILD 

doing and carelessness. For example : if a 
child at the table accidentally breaks a plate, 
we should not consider this a wilful wrong- 
doing. In many instances it is better to let 
the accident pass unnoticed. 

Improper training due to the parents ' or 
nurse 's fault is no reason why a child should 
be punished. In most instances the fault 
is not so much with the child as with the 
mother or nurse. 

To train a child to be patient, kind, and 
gentle, be patient, kind, and gentle yourself. 

A peculiarity of human nature is that 
where there is but one child in the family, 
it is usually a spoiled child. It seems that 
nature intended mothers to have large 
families, and thus divide the supervision 
and attention, and bestow less devotion on 

the one child. That there are exceptions 
to this rule goes without saying. 

[54] 



Chapter IX 

NERVOUS CHILDREN 

Suggestions for Their Development and 
Training 

Nekvous children dread examinations; 
they also dread punishment; and it is this 
dread or fear that will sometimes result in 
extremes. The neurotic child requires mus- 
cular training, athletics of all kinds, rowing, 
and especially swimming. Swimming is 
especially useful, as the cold water tones 
the muscles and nerves while the exercise 
strengthens and develops the same. This 
physical development invariably balances 
the highly strung neurotic child. If, how- 
ever, we give to a nervous child additional 
home lessons and constantly watch each 
move and step with strict discipline, the 
result will be that an occasional neurotic 

[55] 



HEALTH-CARE OF THE GROWING CHILD 

child unable to stand the mental strain will 
suffer a mental breakdown. It is well to 
remember this, because these unhappy re- 
sults can be prevented if a stern parent will 
realize that a child has certain rights which 
should be respected and which need consid- 
eration just as well as a careful parent 
would supervise the diet. 

Nervous children desire sympathy; they 
complain frequently and make much out of 
trivial symptoms. Sometimes it is difficult 
to distinguish between major and minor ail- 
ments. Such children, therefore, require 
special training. Their lives should be filled 
with thoughts foreign to the body, so that 
they are kept busy. In this manner we con- 
centrate the attention of the child on any- 
thing but himself. While sympathy and 
gentleness, rather than firmness, should be 
the rule, it should be done with a spirit of 
apparent indifference on the part of the 

[56] 



NERVOUS CHILDREN 

mother or nurse. If a child realizes that 
one is anxious and sympathetic, it is but 
natural for him to take advantage of the 
situation. All children do this ; hence, know- 
ing the peculiar make-up of a child, we 
should restrain and repress our feelings, 
and never shed tears or show other evidence 
of sympathy in the presence of the child. 

Children notice everything, they are keen 
observers of details, but their viewpoint is 
different. 

A nervous child is a normal child in which 
we have a sensitive, highly strung mechan- 
ism requiring careful consideration. 

The proper environment, therefore, for a 
nervous child is one in which a quiet atmos- 
phere exists. To surround a child with a 
nervous, hysterical family and friends is 
adding fuel to the flames. Such children 
can not stand overtraining and exacting 
discipline. 

[57] 



Chapter X 
PRECOCIOUS CHILDREN 

Precocious children manifest their supe- 
rior mental equipment very early in life. 
Such children are keen observers of all de- 
tails. They hear, see, and grasp quicker 
than the average child. Because of this 
higher mental adaptability they are fre- 
quently pushed farther ahead than their 
physical strength permits. 

Teachers at school welcome such pupils, 
because they are so bright. It is important 
for the parents to recognize precocity, and 
instead of urging such a child to do more 
and more, we should be careful to restrain 
and lessen the mental burden, lest a mental 
breakdown occurs. 

Athletics is the important medicine to 

[58] 



PKECOCIOUS CHILDEEN 

develop the muscles and to strengthen the 
nerves. It equalizes the circulation of the 
blood, especially where a tendency to con- 
gestion of the brain exists. This conges- 
tion of the brain is a normal result of pre- 
cocity. Such children tire easily, complain 
of headache, and show fatigue. At such 
times all school-work and lessons must be 
stopped. A radical change from the les- 
sons consists in a game of ball or in playing 
a musical instrument, or listening to music. 
This will distract the mind, and relax the 
nerve-tension, at the same time soothing 
the highly strung child. 

A tepid bath followed by a cold shower 
is the best means of relieving an overworked 
child. (For hygienic management read ar- 
ticle on Nervous Children.) 



[59] 



Chapter XI 
THE BREATH 

Foul odors are frequently noted from a 
child 's month. They always have some sig- 
nificance. We should, therefore, seek their 
origin or cause. These odors may be due 
to decaying teeth, they may also be caused 
by an ulcerated tooth or an abscess in the 
mouth or gum. 

More often a bad breath is due to gaseous 
fermentation arising from the stomach. In 
indigestion and dyspeptic conditions foul 
odors from the breath are noted. Chronic 
swelling of the tonsils and adenoids will 
give off catarrhal discharges, and these dis- 
charges have a foul, putrid odor. We should 
go slow, therefore, in ascribing a foul breath 
to a coated tongue until all other causes 

[60] 



THE BEEATH 

have been eliminated. Sprew or thrush will 
frequently be the cause of a foul breath. 

A laxative, such as a teaspoonful of senna 
leaves boiled in a teacupful of water and 
strained, to which two tea spoonfuls of rasp- 
berry sirup are added, may be given one- 
half hour before breakfast, and repeated 
one-half hour before retiring, to a child of 
from five to ten years old. If the foul breath 
is due to dyspeptic fermentation or catarrh, 
this will quickly remedy it. 

When belching and eructation of gas con- 
tinue for many days, we must reduce starchy 
foods, and stop cereals. Eelief is frequently 
afforded by giving a tablet of Bulgarian 
bacillus after each meal. If foul breath con- 
tinues after the above remedies are tried, a 
dentist should be consulted to see whether 
or no the teeth are responsible. This will 
be discussed in the following chapter. 

[61] 



Chapter XII 
THE TEETH 

The teeth require thorough cleansing to 
prevent decay. No particles of food should 
be allowed to remain between the teeth. 
Decaying food gives off acids which cause 
the teeth to rot. The teeth require plenty 
of exercise. The chewing of coarse food is 
the best exercise for them. When coarse 
food is properly chewed it not only strength- 
ens the teeth, but massages the gums. The 
teeth should be brushed with an alkaline 
solution. Half a teaspoonful of bicarbonate 
of soda in a tumblerful of lukewarm water 
is best for this purpose. After brushing 
the teeth with this solution the mouth should 
be thoroughly rinsed with the same. 

To keep the teeth in proper condition they 

[62] 



THE TEETH 

should be cleaned after each meal. The 
brush should be scalded daily, to destroy 
germs and cleanse the bristles. 

Decayed teeth result in foul breath, in- Decayed Teeth 
flammatory condition of the gums, and fre- 
quently alveolar abscess. The constant 
presence of pus back of the decayed tooth 
gives rise to foul breath and enters the 
system with the food during mastication. 
From this pus-poison, headache, and fre- 
quently anemia, result. 

Decayed teeth, commonly known as ' i den- 
tal caries," when present in the milk-teeth 
(temporary teeth) can spread to the under- 
lying permanent teeth. It is obvious, there- 
fore, that caries affecting the temporary 
teeth is a very serious matter and one that 
should not be neglected by the mother. 

Eecently the Board of Health and the 
Department of Education in the City of 
New York began an active crusade in the 

[63] 



HEALTH-CAKE OF THE GKOWING CHILD 

interest of a healthy mouth. The tooth- 
brush drill, stimulated by the offer of a 
prize for the child with the cleanest month 
and teeth, is an effectual method of instill- 
ing the necessity for a daily oral hygiene. 

The gums, teeth, salivary glands, and ton- 
sils are neighbors, and disease of one can 
spread to the others. It is quite likely that 
just as the glands below the jaw swell and 
participate in active inflammation within 
the mouth from the teeth, so, perhaps, do 
disorders of the teeth and gums spread to 
the tonsils, 
irregular About the seventh year the milk teeth 

loosen and fall out and give way to the 
permanent teeth. The permanent teeth 
should be carefully watched, and if they 
appear irregularly the dentist should be 
consulted. Teeth can easily be braced and 
straightened if they appear irregularly. 
Some teeth will grow sideways instead of 

[64] 



Teeth 



THE TEETH 

in their regular, natural manner. To cor- 
rect this the dentist should be consulted as 
early as possible. In blood disorders such 
as syphilis and tuberculosis the teeth show 
the evidence of the same constitutional dis- 
ease. As the blood, bones, and muscles re- 
quire treatment, so will the teeth demand 
medication to harden them. 

Riggs's disease and pyorrhea alveolaris Riggs's Disease 

and Pyorrhea 

are diseases which require local attention 
of a dentist. Pus-germs will burrow and 
frequently form abscesses under the roots 
of the teeth. 

The milk-teeth should not be removed too Appearance of 

the Permanent 

early. When they become loose it is indica- Teeth 
tive that they are being pushed by the per- 
manent teeth which will soon replace them. 
It should be remembered that the six-year 
molars, often called the six-year-old teeth, 
are the first of the permanent teeth to ap- 
pear. Parents sometimes confuse these 

[65] 



HEALTH-CAKE OF THE GKOWING CHILD 

with milk-teeth and have them pulled. As 
no other teeth will ever take their places, 
spaces will be left in the jaws in after years 
between the wisdom-teeth and the teeth 
farther forward. This will either necessi- 
tate bridge-work or will leave an ugly- 
looking mouth. 

No tooth should be extracted because it 
is sensitive or aches. The advisability of 
extraction is a matter for the dentist alone 
to determine. 

ERUPTION OF THE PERMANENT TEETH. 

The first 4 molars 5th — 7th year. 

The 4 inner incisors 8th year. 

The 4 outer incisors 9th year. 

The 4 anterior bicuspids 10th year. 

The 4 canines 11th — 13th year. 

The 4 posterior bicuspids 12th — 15th year. 

The 4 second molars 13th — 16th year. 

The last 4 molars (wisdom-teeth) 16th — 20th year. 

The decay of the teeth, commonly known 
as dental caries, is caused by the acid due 
to fermentation or putrefaction of parti- 

[66] 



THE TEETH 

cles of food remaining between the teeth. 
Brushing the teeth is only part of the nec- 
essary hygiene. Such bits of food can best 
be removed with dental floss. 

Toothache signifies that a tooth is de- to Relieve 

Toothache 

cayed or decaying. The dentist may save 
the tooth by filling it and preventing the 
decay from spreading. To relieve a tooth- 
ache apply oil of cloves on cotton into the 
hole of the tooth. If oil of cloves is not 
handy, use alcohol instead. If a tooth has 
just been filled and gives pain, rinse the 
mouth with salt water every fifteen minutes. 
Add a teaspoonful of common salt to a tum- 
blerful of warm water. 

For the relief of pain caused by a gum- Gum-boa 
boil, apply a warm raisin poultice, which is 
made by splitting open raisins, removing 
the seeds, adding a few drops of water, and 
heating. Apply warm to the gum. A mus- 
tard foot-bath should also be given. 

[67] 



Chapter XIII 
HYGIENE OF THE HAIR AND SCALP 

The healthy scalp requires washing 
every three or four weeks. In a large city 
where dust and dirt ladened with germs can 
set up an inflammation, weekly and some- 
times daily washings will be demanded. Ac- 
tive playing in the streets with consequent 
perspiration will cause itching of the scalp. 
By scratching the same when covered with 
dust germs, head boils or scalp pustules 
may result. 

Not only is this frequent washing neces- 
sary in the large cities but similar condi- 
tions are found at the seashore where the 
sand will give rise to irritation. After sea 
bathing or lake bathing one is safer to thor- 



HYGIENE OF THE HAIK AND SCALP 

oughly shampoo the scalp at least once a 
week. 
Either tar soap or liquid green soap washing 

the Hair 

should be used. Add enough hot water to 
the soap to make a lather. This lather 
should be thoroughly rubbed into the scalp 
and allowed to remain there about five min- 
utes until it has thoroughly penetrated the 
same; during which time the head may be 
covered or protected with a towel. Warm 
water should then be poured or sprayed on 
the scalp, and with brisk rubbing the lather 
washed away. This lather can be gently 
pressed downward through the hair, but no 
rubbing of the hair is necessary. Many 
quarts of water will be required to wash 
away the lather. Soapy hair will never dry 
or feel comfortable to the head. 

Rub the scalp and hair thoroughly but 
gently with hot soft towels until it is per- 
fectly dry. The heat of the towels will help 

[69] 



HEALTH-CAKE OF THE GROWING CHILD 

evaporate the moisture. One per cent, bo- 
rated vaseline may be applied to the scalp 
and the tips of the hair, if after such a 
thorough shampooing it has become very 
dry. 
The Brush For children select a medium-hard brush 

which has long bristles in the center and 
shorter ones on the circumference. The 
bristles should be arranged in bunches, not 
too close together, the middle bristles of 
each bunch being longer than the surround- 
ing ones. The bristles arranged in this 
manner will penetrate the hair and reach 
down to the impurities which lie on the 
scalp proper. It is the scalp which needs 
the brushing more than the hair. 

The brush should be firmly drawn 
through the hair in such a way that there 
is a feeling of pleasant warmth upon the 
scalp, but not hard enough to cause a sen- 
sation of soreness. 

[70] 



HYGIENE OF THE HAIR AND SCALP 

If the hair is left open and hanging a 
soft even cut brush should be used to 
smooth and polish the hair after it has been 
brushed clean with the stiff brush. 

A comb is used to separate the hair into The comb 
strands. It should be a large comb with 
long teeth set wide apart. The points 
should be dull and the edges rounded, so 
it will go through easily and not tear the 
hair. 

A fine-toothed comb should never be used 
excepting to remove vermin. It should 
never be employed to remove dandruff, for 
it irritates the scalp and increases the 
trouble. 

Both comb and brush should receive a 
weekly bath of ammonia and water, and a 
daily tapping to remove the dust. 

Airing the hair by keeping it uncovered 
is supposed to add vigor to it and keep it 
healthy, but the cause of good or poor hair 

[71] 



HEALTH-CAKE OF THE GKOWING CHILD 

are not dependent upon admission of air to 
the hair, but upon the normal condition of 
the stomach, the liver, the digestion, the 
nerve centers, in fact upon the whole or- 
ganism. 

When children are compelled to remain 
in bed during long periods of illness their 
hair frequently becomes matted. At times 
discharges from the scalp will glue the hair 
together. While in many cases it will be 
necessary to clip or cut the hair, in many 
other cases the hair need not be sacrificed. 

The scalp should first be thoroughly 
washed as above described and after be- 
ing thoroughly dried, a 1 per cent, borated 
vaseline should be thoroughly rubbed into 
each matted part. The mats should be 
gently loosened as much as possible with 
the fingers, after which they should be 
brushed with a wire brush. This wire brush 
consists of a number of bristle-shaped wires 

[72] 



HYGIENE OF THE HAIK AND SCALP 

set singly and far apart in a flexible rubber 
backed hairbrush. Begin brushing at the 
tips of the hair, gradually working upward 
until the scalp is reached. It may require 
days of patient treatment and brushing un- 
til all the mats are disentangled. 



[73] 



Chapter XIV 

GROWTH IN HEIGHT AND WEIGHT 

The following table exhibits the growth, 
in height and weight, of boys and girls from 
the third to the seventeenth year: 





Boys. 


Girls. 


Age. 


Height 
in Inches. 


Weight 
in Pounds. 


Height 
in Inches. 


Weight 
in Pounds. 


3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 


35 

38 

41 

44 

46 

47 

49| 

52 

53£ 

55 

57 

59i 

62£ 

64£ 

66£ 


31 

35 

41 

45 

49£ 

54£ 

60 

66 

72£ 

80 

88 

m 

110 
123 
128 


35 

38 
40£ 
42| 
44£ 

m 

48| 

51 

53 

55J 

57| 

59| 

61 

61| 

62£ 


30 

34 

40 

43£ 

48 

53 

57£ 

64 

70 

79 

89 
100J 
108 
113 
119 



[74] 



Chapter XV 
PUBERTY 

In girls between the age of eleven and 
fifteen years the development of the breasts 
and associated therewith the development 
of the genital organs take place. As this 
is the stepping-stone from childhood into 
womanhood, a radical change takes place 
both in the circulation of the blood and in 
the nervous system. Very many symptoms 
directly due to this change can be noted. It 
is therefore an important point to prepare 
each and every girl for the approaching de- 
velopment and explain to her in plain lan- 
guage the significance of menstruation. 

If a mother feels herself incompetent Menstruation 
to explain these details she should ask a 

[75] 



HEALTH-CAKE OF THE GKOWING CHILD 

trained nurse or her physician to impart 
the necessary information. 

In many schools sex-hygiene is being 
taught. While this is better than no in- 
struction, it is still better for the mother 
to have the child's full confidence, and to 
tell her just what nature intends to do, and 
what it all means. Tell her the number of 
days that she will menstruate and that it 
will recur every month. This function 
should be supervised and each girl taught 
to note the date, every twenty-eight or 
thirty days, for the recurrence of this 
healthful flow. 

Violent exercise, such as swimming, 
horseback riding, golf, and tennis, should 
be omitted during this period. Walking 
moderately is beneficial. A sponge-bath 
with lukewarm water will refresh the body. 
Tub-bathing during the period and for 
twenty-four hours following is prohibited. 

[76] 



PUBEETY 

The diet should be of the simplest charac- 
ter. Iced foods and ice-cream should not 
be permitted. Vinegar and strong acid 
foods are prohibited. The body should be 
well protected with clothing, and rest should 
be enforced so that the young girl is not 
overtaxed. The bowels should be super- 
vised so that a daily movement takes place. 
Several raw figs eaten before breakfast will 
relieve constipation. This simple proce- cramps 
dure of emptying the bowels will frequently 
be all that is necessary to relieve the cramps 
so frequently complained of, which is the 
pressure of a full bowel on the distended 
uterus. 

During cold weather the feet should be 
protected. We should not overtax the ner- 
vous system with too much study. Lessons 
can be postponed and extra home-work 
should not be enforced. 

Every boy approaching puberty requires 

[77] 



HEALTH-CARE OF THE GROWING CHILD 
Male Gemtai supervision and instruction. The boy can 

Development 

not be isolated from the company of boys, 
and thus be will receive instruction in bad 
habits which will be very hard to break. It 
would appear more plausible, therefore, to 
have the father or the uncle or the physi- 
cian give such instruction as will impart the 
knowledge of the development of the genital 
organs, their uses, and their abuses. There 
are many ways of approaching this subject 
and making it instructive without picturing 
horrors and frightening the frail, growing, 
nervous boy because one wishes to keep him 
sexually pure. 
Masturbation Of all the bad habits one should try to 
prevent the most important is masturbation. 
We can instruct the boy in nature 's method 
of development of the organs and their nat- 
ural seminal emissions. These take place 
voluntarily without masturbation or sexual 
intercourse. These emissions take place 

[78] 



PUBERTY 

normally once every one or two months and 
consist of a loss of an excess of seminal 
fluid.* The frequency of their recurrence 
usually depends on the amount of sexual 
thought or stimulation. In some boys a 
glass of wine or beer is sufficient to excite 
or provoke an emission. In others, female 
society will so excite the boy that he will 
have an emission at night. 

Such information should be imparted to 
every boy, that he may know nature re- 
sponds to various forms of excitement, be 
they alcoholic or sexual, and that the occa- 
sional loss of fluid at night is not harmful. 

Do not allow boys to read trashy litera- 
ture with which the country is flooded, and 
which is sent out by fake medicine compa- 
nies to impress and frighten the boy, for 
business reasons. 

*At times a glairy fluid resembling mucus follows 
excitement, the loss of which is not detrimental to 
the system. 

[79] 



HEALTH-CAKE OF THE GKOWING CHILD 

The habit of masturbation is dangerous 
because of the ease with which the act is 
performed, and because when once formed 
the boy will be backward, languid, tired, 
heavy, and nervous. Such boys have dark 
rings under their eyes, and they appear 
dull. The feet and hands show a cold, clam- 
my perspiration, and they are neither sick 
nor well. They lose ambition and do not 
push ahead. They are the so-called dul- 
lards. As a rule, if questioned they will 
deny the habit, and it is only after they have 
been told that the symptoms of such self- 
abuse is stamped on their face that we can 
compel them to admit the habit. 

To treat this habit a cold shower or cold 
bath or a spinal douche should be ordered. 
Walking in the open air is excellent. The 
quantity of meat should be reduced, and 
milk, vegetables, and fruits given liberally. 
Large quantities of water or lemonade 

[80] 



PUBERTY 

should be ordered, but neither wine nor al- 
coholic beverages should be permitted. Tea 
and coffee also should be prohibited. Cool- 
ing and nutritious food, such as milk, butter- 
milk, cocoa, and malted milk, may be per- 
mitted. Spices and highly seasoned foods 
should not be given. 

Very warm clothing should not be worn 
next the body. Cotton or linen should be 
substituted for flannels. 

My plan has been to give every boy the 
benefit of the doubt and warn him besides 
giving him the above outlined treatment. 
If, however, we note after several weeks or 
months that the boy has resumed his former 
habits, then we can resort to sterner meas- 
ures, and remind him that nervous break- 
down, mental breakdown, and even insanity 
can follow if he does not master the situa- 
tion and control the habit. 

It is important, as the boy reaches pu- 

[81] 



HEALTH-CAKE OF THE GKOWING CHILD 

Advice to Boys berty, to warn him of the dangers that ex- 
ist in life. Sexual intercourse with a dis- 
eased girl may be the means of inoculating 
him with syphilis, which will prove a very 
costly lesson. The danger of being inocu- 
lated with gonorrhea while a poison of a 
lesser degree, can also prove costly. If the 
discharges from a boy diseased with gonor- 
rhea should accidentally be rubbed into an 
eye, blindness may result therefrom. Such 
apparently trivial conditions are important 
enough for every parent to know, and to 
impart such knowledge to a growing boy, 
always having in mind that by so doing we 
may prevent him from contracting such a 
disease. 

care of the The female child should be washed with 

Genital Organs 

soap and water. Unless there is a special 
reason, and it is ordered by the physician, 
no dusting powders nor salves should be 
applied. Small deposits of dusting-powder 

[82] 



PUEEKTY 

combined with any possible discharge may- 
adhere like glue and frequently be the cause 
of inflammatory adhesions, which produce 
an irritation and may later give rise to the 
habit of masturbation. 

In the male child not circumcised, the 
foreskin should be pushed back over the 
glans, and all accumulations removed with 
soap and water while in the bath. Particles 
of cheese-like deposit which do not readily 
wash away may be removed with cotton and 
warm oil. 

No more or frequent handling of these 
parts than is absolutely necessary should be 
done because of the danger of starting the 
habit of masturbation. Children who do 
not have a tendency to discharges, but who 
have a dry mucous membrane, may not re- 
quire these genital baths more frequently 
than once a month. 

[83] 



Chapter XVI 
VACCINATION 

We vaccinate a child with virus taken 
from a cow and induce a disease which pro- 
tects the child against smallpox. Any one 
familiar with the history of the ravages of 
smallpox before the introduction of vaccina- 
tion will remember the enormous mortality 
which prevailed and the untold suffering 
and pock-marks in those that recovered. 

Vaccination properly performed consists 
in cleansing the skin so that no germs or 
filth can enter the wound and contaminate 
the virus used. It is better to leave the 
vaccination of a child to the physician. No 
mother or nurse should undertake to vac- 
cinate the child. There is no danger in 
vaccination if properly done, on the con- 

[84] 




Small-pox in an Unvaccinated Child. Vaccination with cow- 
pox would have prevented the above (Shamberg). 



VACCINATION 

trary, there is only the assurance of pro- 
tection if an epidemic of smallpox should 
arise. 

During the active stage of the vaccination 
the child should be isolated as well as pos- 
sible from any one suffering from a conta- 
gious disease. The germs of erysipelas and 
diphtheria readily enter a fresh vaccination 
so that if any one is ill in the same house, 
it is better to postpone the vaccination un- 
til after the patient recovers. 

Five to seven days after inoculation, in- 
flammation or redness around the inoculated 
area will be noted. This is the natural 
course of taking. If this redness spreads 
and the skin is swollen and tense, the physi- 
cian will usually prescribe a cooling moist 
dressing of lead-water or a one per cent, 
boric acid solution. The inflamed surface is 
covered with several layers of gauze satu- 
rated with one of these solutions until the 

[85] 



HEALTH-CAKE OF THE GKOWING CHILD 

inflammation subsides; this usually takes 
two or three days. 

One inoculation will protect a child about 
five years. It is necessary, therefore, to 
revaccinate every five or six years. 

During the active stage of vaccination 
the diet should be restricted to milk, cereals, 
broth, vegetables, and fruit. No meat or 
eggs should be given. Water should be 
given liberally, also all fruit-juices. 

The bowels should be watched and if con- 
stipated raw figs with senna leaves should 
be given before breakfast. Stewed peaches, 
prunes, and apricots will aid in keeping the 
bowels loose. A shield is unnecessary. A 
piece of gauze or linen sufficiently large to 
protect the wound from the clothing should 
be placed over the vaccinated area and 
changed every morning and evening. Do 
not apply salves. If the linen or gauze ad- 
heres to the wound, soak it loose with oil. 

[86] 



VACCINATION 

As a rule, the active stage persists sev- 
eral weeks. Even though there has been a 
temperature of 100 or 103 degrees, there 
is no danger to be feared. A vaccinated 
child should receive its daily bath and 
should play and go to school as though noth- 
ing had happened. It is only if active in- 
flammation follows that we should keep the 
child quiet at home, or if it has fever over 
101 degrees. 



[87] 



Chapter XVII 
TEMPERATURE— FEVER 

The normal temperature of the body, 
taken in the month, is 98% degrees. If 
taken in the rectum it varies between 99% 
and 99% degrees. A temperature, therefore, 
under 100 degrees in the rectum should be 
regarded as normal. If it is higher it shows 
some derangement of the system. 

Active and excitable children always have 
a slight rise in temperature. For example : 
if a child plays vigorously it may develop 
a temperature of 100% degrees in the rec- 
tum, and after resting the body an hour 
the temperature will go back to normal. A 
child that is easy-going will usually have 
a lower temperature than one with an ex- 

[88] 



TEMPERATURE— FEVEK 

citable temperament. Nervous children 
have higher temperatures than the phleg- 
matic type of child. 

There is a slight difference between the 
morning and the evening temperature. It 
is usually about 99 degrees in the morning 
and about 99% degrees in the evening. This 
is a normal variation. No one can judge 
temperature by feeling the surface of the 
body with the hand. To be accurate we 
must always employ a clinical thermometer. 

In taking the temperature, shake the to Take 

Temperature 

thermometer so that the column of mercury 
drops below 95 degrees. Apply vaseline 
or oil to the end containing the mercury. 
Place the child on the left side and insert 
the thermometer one inch into the rectum. 
Let it remain two to three minutes. The 
end of the column of mercury indicates the 
degree of temperature. The thermometer 
should be washed with soap and cold water. 

[89] 



HEALTH-CAKE OF THE GROWING CHILD 

The mercury remains registered in the tube 
until it is again shaken down. 

The value of the thermometer in recog- 
nizing fever is well known. It is especially 
valuable when the child is peevish or rest- 
less. It is a serious mistake to discipline 
a child for naughtiness if it is suffer- 
ing from fever. To detect fever we must 
use a thermometer. A healthy child will 
have a normal temperature, a sick child 
will have fever. When children breed dis- 
ease, as for example before the eruption of 
measles, scarlet fever, or diphtheria, they 
are dissatisfied, sensitive, and will not eat. 
To spank such a child or force it to eat a 
full meal regardless of its tolerance for 
the food is inviting trouble. If however 
the temperature is taken, we can recognize 
the presence or absence of illness. Thus 
my advice is, use a thermometer if in doubt, 
but do not use a thermometer daily or 

[90] 



TEMPERATURE— FEVER 

several times a day as a matter of rou- 
tine. 

Fever in an older child signifies more significance 

of Fever 

than it would in an infant. The body is 
older, the system is stronger, and there is 
usually more resistance to disease than in 
infancy. Notwithstanding this there are 
distinct diseases to which childhood is sus- 
ceptible. Every mother therefore should 
bear in mind that while fever may be caused 
by a spoiled stomach or intestinal stagna- 
tion of stool, the large majority of fever- 
attacks are due to other causes. 

Every mother should think of the possi- 
bility of her child breeding a disease. A 
slight cold in the head with fever may be 
influenza or grippe, but it also may mean 
the development of measles. In like man- 
ner fever and vomiting with loss of appetite 
may be due to indigestion or an overloaded 
stomach, but it may also be due to the be- 

[91] 



HEALTH-CARE OF THE GROWING CHILD 

ginning of scarlet fever. Loss of appetite 
— refusal to eat — may be due to a spoiled 
stomach, but it is also well known that a 
child will refuse to eat when it has a sore 
throat and perhaps not enough ability to 
locate the pain in the throat. 

From what has been said it is safer to 
keep a child in bed for several days if a 
temperature of 101 degrees or higher exists, 
until the temperature becomes normal. No 
one would care to have a child walking 
around in the street for the sake of "hard- 
ening" it and suddenly find a day or two 
later that the child was suffering with 
measles or scarlet fever. Such risks may 
prove costly and occasionally fatal. 
Feeding At the beginning of fever put the child 

During Fever 

to bed and stop all solid food. Give milk, 
soup, or broth. Orange-juice or lemonade 
for thirst. Calomel, one-fourth grain, re- 
peated every fifteen minutes until four 

[92] 



TEMPEKATUKE— FEVER 

doses are given, and then followed by a tea- 
spoonful of rhubarb and soda mixture every 
hour until three doses have been given. 
Water should be given frequently. If at- 
tention to the diet and the cleansing of the 
stomach and bowels does not bring the fever 
down within twenty-four hours, call a phy- 
sician. 

If a child is well in the morning and de- sudden Fever 
velops a sudden rise in temperature of 103 
or 104 degrees in the evening, we should 
suspect stomach- or bowel- trouble. An 
enema of soap-water will rapidly eliminate 
stagnating or decomposed stool and there- 
with reduce the temperature. 

Sudden high temperatures are not as se- 
rious as low, gradually increasing fever. A 
temperature that starts with 100 degrees 
and gradually rises one-half or one degree 
more each day signifies a slowly developing 
disease somewhere in the body. It may be 

[93] 



HEALTH-CAKE OF THE GROWING CHILD 

an abscess, it may also be typhoid fever, 
scarlet fever, or kidney-disease. Note if the 
scanty urine urine is scanty ; if so we can eliminate poi- 
sons through the kidneys by giving 15 drops 
of sweet spirits of niter every hour until 
five doses have been given. If the head is 
very hot and the feet are cold, a mustard 
foot-bath should be given, and cold cloths 
applied to the forehead and around the 
neck. Sponging the body with alcohol and 
cold water will be found soothing and will 
reduce the fever. 

If a rash develops during the course of 
fever, isolate the child until the physician 
can see the case. 



[94] 



PAET II 
NUTRITION 



[95] 



Chapter I 

THE DIET 

All children cannot he fed alike. As 
every face is different, so is each and every 
stomach a law unto itself. One child can 
digest food that will render another dys- individual 

Requirements 

peptic. Then again, certain children re- 
quire special articles of food that others 
do not. A lean and constipated child re- 
quires fat in the form of hutter or cream 
or bacon, and a given quantity of starchy 
food, such as potato. In this same type of 
child fruit and fruit juices are demanded 
to offset the usual tendency to stagnation 
of the stool. Very fat children, and espe- 
cially those having a tendency to loose 
bowels, should receive less fruit, less hutter 
and no cream, but should be given a large 

[97] 



HEALTH-CAKE OF THE GROWING CHILD 

variety of vegetables, chiefly spinach, peas, 
beans, lettuce and beets. 

The feeding of children is most impor- 
tant. By giving proper food at proper 
intervals, growth and development take 
place. Many diseases in childhood are due 
to and caused by improper feeding. Every 
mother should know about these diseases so 
that she can guard against them. 
Peculiarities Children have peculiarities, their likes 

in Taste 

and dislikes. One child will require sweet- 
ened food, while another, equally healthy, 
will crave salted foods. Some will refuse 
an undisguised egg, but will eat eggs in 
the form of a custard or flavored omelet. 
A mild relish or sauce will frequently be 
the means of cultivating a taste for meat, 
when meat alone may be refused. I do not 
advocate giving spices or condiments as a 
rule, but there are times when children 
will literally go on a hunger-strike, if some 

[98] 



THE DIET 

of their little whims are not gratified. 
Children will seldom submit to force. 
Many of them are so disgusted with forced 
feeding methods that they will vomit after 
partaking of a forced meal at which they 
rebelled. This is especially true of the 
nervous, sensitive, highly strung child. 

Many mothers have a mistaken notion Miik 
that children up to adolescence must take 
at least a quart of milk a day, in addition 
to their regular diet. This is Unnecessary 
and frequently promotes dyspeptic condi- 
tions by overtaxing the stomach after it 
has partaken of a full meal. 

It is impossible to state the quantity of Quantity 

r ^ J Required 

food a child of three, six, or nine years 
requires, because the capacity of every 
stomach varies and the digestion also 
varies. One child can assimilate twice as 
much meat as another. The same applies 
to the total quantity of vegetables par- 

[99] 



HEALTH-CAKE OF THE GEOWING CHILD 

taken. There is no hard and fast rule that 
can be applied to each and every child. 
Feeding After the third year and until the sixth 

Interval J 

year the child should be given three meals 
a day— at from 6.00 to 7.00 A.M., from 
12.00 to 1.00 P.M., and from 5.30 to 6 P.M. 
There is no objection to giving a glass of 
milk or weak cocoa between meals if the 
child asks for it. If, however, there is a 
tendency to constipation, then one may 
give a cup of malted milk or buttermilk 
between meals. 

The following diets can be used as a 
guide: 

For a Child Three to Six Years Old 

Breakfast: 7.00 to 7.30 

Orange, apple sauce, prunes, or figs. 

Saucer of farina, cream of wheat, yellow corn- 
meal, oatmeal, hominy, or wheatena. (All 
cereals to be steamed in water at least two 
hours. Served with cream and sugar.) 

'[100] 



THE DIET 

If appetite warrants it — a coddled egg and strip 

of bacon. 
Roll, toast, or corn muffin. If constipated, bran 

muffin. 
Cup of milk or cocoa. 

Dinner: 12.00 to 1.00 

Chicken, lamb, beef, or vegetable soup, expressed 
steak-juice. 

Calf 's foot or chicken jelly, raw scraped steak, 
minced chicken, or fish. 

Spinach, peas, beans, young carrots, beets, 
asparagus, cauliflower, baked or creamed 
potato. 

Stewed apples, peaches, apricots, prunes, or 
berries. Sponge cake, ladyfinger, or gela- 
tine pudding. 

Water. 

Supper: 5.30 

Two poached or scrambled eggs, ham or jelly 
omelet. Custard, junket, corn-starch or 
tapioca pudding. 

Cream cheese. 

Bread and butter. 

Sliced banana with milk or raw fresh fruit. 

Cup of milk, malted milk or cocoa. 

[101] 



HEALTH-CARE OF THE GROWING CHILD 

For a Child with Weak Digestion, from Six 
to Ten Years Old 

Many children of the neurotic type have a 
peculiar palate. They crave a change of 
diet and tire easily if the same flavor is con- 
tinned. I have accordingly arranged a se- 
ries of diets which can be varied from day 
to day, so that the most capricious appetite 
can be gratified. 

Breakfast 

Cream of wheat and cut figs, served with cream. 
Soft-boiled egg. 
Corn bread. 
Cup of milk. 

Or: 

Wheatena cooked with dates, served with cream. 
Wheat cakes and maple syrup. 
Graham bread. 

Malted milk (four teaspoonfuls Horlick's malted 
milk to a teacup of hot water). 

Or: 

Oatmeal with cream. 
Egg poached in bouillon. 

[102] 



THE DIET 

French roll. 
Cup of cocoa. 

Or: 
Farina and seeded raisins with cream. 
Broiled bacon or ham with creamed potato. 
Whole wheat bread. 
Cup of malted milk. 

Or: 

Baked apple with cream. 

Hominy. 

Corn bread. 

Cup of milk. 

Or: 

Orange. 

Scrambled eggs with minced tongue or ham. 

Toast. 

Cup of cocoa. 

If constipated a saucer of Kellogg 's bran may 
be given as a cereal, or two teaspoonfuls of 
bran may be mixed with the cereal. 

Lunch 

Split pea soup. 
Lamb chops. 
Baked potato. 
Ladyfingers and jam. 
Water. 

[103] 



HEALTH-CAKE OF THE GROWING CHILD 

Or: 
Noodle soup. 

Fried halibut or fresh mackerel. 
Spinach. 

Baked apple with cream. 
Wafers and water. 

Or: 

Cream of celery. 

Broiled chicken, squab, or creamed chicken on 

toast. 
Asparagus. 

Prune jelly with cream. 
Water. 

Or: 
Beef and sago soup. 
Bluefish or flounder. 
Young carrots. 
Apple sauce. 
Wafers and water. 

Or: 

Cream of asparagus or vegetable soup. 
Broiled sweetbread or stewed tripe. 
Baked sweet potato. 
Angel-cake. 

Or: 
Chicken and rice soup. 
Roast beef, steak, codfish or smelts. 

[104] 



THE DIET 

Peas. 

Celery. 

Stewed peaches or apricots. 

Wafers and water. 

Supper 

Glass of zoolak or buttermilk. 

Cream cheese. 

Toast. • 

Apple or fresh fruit. 

Or: 

Ham omelet. 

Toast. 

Glass of milk. 

Grapes. 

Or: 
Baked macaroni with cheese. 
Fresh lettuce or celery with salt. 
Cup of cocoa. 
Imported Albert crackers. 

Or: 

Scrambled eggs. 

Split banana baked in shell. 

Saltines. 

Glass of milk. 

Or: 

Rice pudding with almonds and raisins. 

[105] 



HEALTH-CAKE OP THE GROWING CHILD 

Cup of malted milk. 
Bread with butter and jam. 
Fresh fruit. 

Or: 

Apple or cherry custard. 
Cream cheese. 
Saltines. 
Cup of cocoa. 

Or: 

Jelly omelet. 
Swiss cheese. 
Uneeda biscuit. 
Cup of cocoa. 

Or: 

Cold breast of chicken. 
Lettuce or celery with salt. 
Sliced pineapple with cherries. 
Glass of milk. 

In feeding a child of from ten to sixteen 
years, we should remember that the child is 
still growing, and that his individual re- 
quirements are vegetables, cereals, fruits, 
eggs, fish, and meat. Instead of one egg, 
two may be given at a meal. Wheat bread 

[106] 



THE DIET 

is very nutritious ; if, however, it has a ten- 
dency to constipate, then bran or Graham 
bread may be given. Corn bread baked in 
the morning may be served in the evening. 

Diet for a Child over Ten Years of Age 

Morning 

Raw fruit in season. 

Wheatena, oatmeal, farina, cream of wheat, 
corn-meal grape nuts, wheat flakes or shred- 
ded wheat biscuit. 

Ham or bacon and eggs. 

Corn or bran muffins, wheat or Graham bread, 
rolls. 

Water, milk, or cocoa. 

Noon 

Chicken, beef and noodle, mutton, and all vege- soups 

table soups. 
Lamb chops, steak, roast beef, chicken, fish, raw Meats 

chopped beef, lamb or beef stew. 
Peas, beans, carrots, beets, potato, corn, cauli- vegetables 

flower, or asparagus. 
Celery, lettuce, tomato. 

[107] 



HEALTH-CARE OF THE GROWING CHILD 

Dessert Berry pies, corn-starch, tapioca, custard, or 

stewed fruits. 
Wheat or Graham bread. 
Water. 

Evening 

Scrambled eggs or omelet. 

Cold chicken, lamb, or ham. 

Swiss or cream cheese. 

Custard or sponge-cake. 

Bread, butter, and jam. 

Fruit. 

Water, milk, or buttermilk. 

Diet for an Underweight Child 

To increase a child's weight, certain in- 
gredients of the food must be modified. 
This will alter the general nutrition of the 
body and give more weight. A word of cau- 
tion is necessary. Do not force the change 
from a light diet to a richer and more con- 
centrated form of food too suddenly, as 
thereby we may overtax the digestive func- 
tion and induce dyspepsia, which may per- 
manently weaken the stomach. 

[108] 



THE DIET 

To increase the weight of a child we must 
increase the fat content of the food. A tea- 
spoonful of cream added to a cup of milk 
several times a day is indicated. If this 
cream is well digested and causes no dis- 
turbance we may add another teaspoonful 
of cream and increase in four or five days 
until three teaspoonfuls are added to each 
cup. Butter should be given liberally. It 
may be given on bread or potato. Sugar 
may be given liberally on cereals and pud- 
dings. If cereals such as farina, cream of 
wheat, Pettij ohn, or wheat ena are well 
borne they should be given at least once a 
day. They should be served with cream or 
butter, and sugar. 

For the noon meal, puddings, such as 
tapioca, arrowroot, or corn-starch, may be 
given. Macaroni and home-made noodles 
are very nutritious and increase weight. 
Beets, carrots, potatoes, peas, beans, and 

[109] 



HEALTH-CAKE OF THE GROWING CHILD 

lentils are vegetables that add greatly to 
both nutrition and weight of the body. 
Omelet, pancake, sponge-cake, rice pudding, 
and custard, are desserts which are very 
nutritious and increase the weight. 

Olive oil may be given as a dressing on 
lettuce. Cocoa, chocolate, nuts, bacon, and 
eggs will aid nutrition. 

Diet for a Very Fat Child 

Reduction Before reducing the weight of a child we 

should have the heart carefully examined. 
In some cases it is important to have a 
blood-examination made. This examina- 
tion will determine the number of red blood- 
cells, which is a good guide to go by during 
the reduction-treatment, as thereby we can 
learn whether or no the blood supply has 
been weakened by the restricted diet. 

If the reduction is accomplished too rap- 
idly it will be at the expense of the general 

[no] 



Diet 



THE DIET 

blood supply. A weak heart and collapse 
may result therefrom. 

The diet for children with a tendency to 
fat formation should have the quantity of 
liquids restricted, thus very small quanti- 
ties of milk, soup, broth, or even water 
should be given. Fat children should re- 
ceive small quantities of meat and fish, but 
large portions of vegetables and fruits 
should form the bulk of their diet. 

It is very important to assist the bowels 
by giving a laxative that will carry off 
fluids. One of the best laxatives for this 
purpose is the lapactic pill. This may be 
given before retiring at night and may be 
repeated every evening until liquid stools 
are produced daily. 

Cereals, butter, and cream should be given 
in very small quantities. Eggs, fish, lean 
beef, ham, lamb, and veal in moderation. 

Candies, cakes, and nuts are prohibited. 

[in] 



HEALTH-CAEE OF THE GKOWING CHILD 
Diet in Fever 

When fever occurs all solid food should 
be stopped. By fever is meant a tempera- 
ture higher than 101 degrees. Eggs, meat, 
vegetables, and cereals should be omitted. 
Milk, gruel, broths, fruit juices, and in rare 
instances junket, gelatine, toast, and bis- 
cuit may be given. These diets are to be 
given only until the physician can examine 
the patient. 

In many surgical conditions, where the 
digestive tract is normal, and no fever ex- 
ists, it may be possible to give a full diet of 
meat, eggs, and vegetables to hasten repair 
and aid in recovery. 

Diet in Diarrhea 

If ordinary looseness of the bowels exists 
and there is but a slight rise in the tempera- 
ture, give a good dose of castor-oil and stop 
all milk. Give rice, steamed in water, mut- 

[112] 



THE DIET 

ton, lamb, or veal broth with rice or barley, 
toast, corn-starch, or tapioca pudding, jun- 
ket or cream cheese. No fruits should be 
given. For thirst, weak tea or water may 
be given. Albuminized tea, or tea contain- 
ing the white of egg, may be given many 
days in succession. An interval of at least 
four hours is required between feedings. 

Poor Appetite 

Poor appetite may be due to a general 
weakness of the stomach or a loss of tone. 
It may also be due to a catarrhal condition. 
When children suffer with nasal catarrh, 
adenoids, or enlarged tonsils they will in- 
directly disturb the stomach and thereby 
cause a loss of appetite. Constipated chil- 
dren usually suffer with loss of appetite. 
When the stool stagnates in the bowel, we 
must cleanse the intestines with a teaspoon- 
ful of Epsom salts or Eochelle salts dis- 

[113] 



HEALTH-CARE OF THE GEOWING CHILD 

solved in sweetened water. This dose may- 
be given two mornings in succession, then 
omitted for three or four mornings. 

One of the best drugs to kindle an appe- 
tite is one or two drops of tincture of nux 
vomica one-half hour before each meal for 
one month. This dose is safe for a child of 
any age. Large doses should not be given 
without the direction of a physician. 

Very nervous children, especially those 
having strenuous work at school, will do best 
by omitting school lessons, and being given 
a complete rest for a day or two in bed. 

Many other children will regain their ap- 
petite by being given a change of air. A 
change from the city to the country or sea- 
shore or from the country to the city will 
stimulate the appetite. 

A cold sponge-bath or cold shower, fol- 
lowed by a brisk rub, is one of the best 
appetizers. 

[114] 



THE DIET 

A radical change in diet in which milk is 
omitted can be tried for two days. Or, if 
meat, eggs, and vegetables have formed the 
bulk of the diet, let the stomach rest by giv- 
ing a teacupful of milk, but nothing else, 
three times a day. After three or four days 
we can gradually return to the former diet. 

Vomiting 

Vomiting is not always a sign of disease. 
If the stomach is very irritable, food may 
provoke a spasm which results in vomiting. 
In very nervous and sensitive children vom- 
iting takes place easier than in the strong 
and robust child. Vomiting is usually due 
to a disordered stomach. It may also be 
due to swollen tonsils or may be caused by 
fright. As a rule, vomiting means the be- 
ginning of a disease. When a child strikes 
its head and has a concussion of the brain, 
vomiting results. Continued vomiting, as- 

[115] 



Vomit 



HEALTH-CARE OF THE GROWING CHILD 

sociated with fever, may mean the begin- 
ning of scarlet fever or brain disease. 
Nervous Habitual vomiting may be caused by a 

growth in the stomach. It may also be due 
to a nervous manifestation. The hysterical 
and sensitive child, especially if it is forced 
to eat food that it does not like, will throw 
it up. This form of vomit depends on the 
nervous mechanism of the child, and a case 
of this kind requires judgment and treat- 
ment of the whole nervous system rather 
than that of the stomach. 

Vomiting is sometimes caused by acido- 
sis. In this condition there is headache, 
fever and a sour breath resembling the odor 
of vinegar. The urine contains diacetic acid 
and acetone. These attacks may occur in 
the best of families^ in children having ex- 
cellent supervision. They are not caused 
by imprudence in feeding. If meat or eggs 
are the causative agents, stop them. Some 

[116] 



THE DIET 

children may require a milk or vegetable 
diet for many months. If egg and meat 
proteins act as irritants, they must be omit- 
ted from the diet. Internally one-half tea- 
spoonful or more of bicarbonate of soda 
three or four times a day will stop the 
attacks. 



[117] 



Chapter II 

DISORDERS ARISING FROM IM- 
PROPER NUTRITION 

The Bowels 
supervision of It is better not to rely on the statement 

the Bowels 

of any child regarding the bowels. No child 
up to the age of puberty is competent to 
describe a stool as to size, color, consistency, 
or quantity. The yellowish, pasty stool or 
the yellowish-white stool of infancy is 
changed to the brown, formed stool which 
should be passed in long-formed, sausage- 
like masses. Hard, round, and dry balls 
signify the absence of secretions from the 
liver, also the absence of intestinal glandu- 
lar juices. These secretions are necessary 
to soften as well as lubricate the stool, thus 
keeping it in a semisolid consistency. 

[118] 



IMPEOPEE NUTEITION 

Many stools contain particles of undigest- 
ed vegetables and meats. This indicates 
lack of proper mastication. This has been 
mentioned in the article on Intestinal Indi- 
gestion. 

When children eat too quickly and do not Proper 

Mastication 

take time to properly masticate their food, 
they should be served with chopped or 
minced meats, puree of peas, potatoes, etc. 
Proper mastication can only be taught by' 
constant and patient supervision. Some 
children of the nervous and overactive type 
do everything quickly, likewise they eat 
quickly, hence one must expect frequent 
dyspeptic attacks resulting therefrom. A 
dyspeptic stomach means dyspeptic stools. 

Constipation 

The bowels must move at least once 
in twenty-four hours, otherwise the child 
is constipated. Health and development, 

[119] 



HEALTH-CAKE OF THE GKOWING CHILD 

which means growth, are dependent on the 
digestive tract. 

The absorption of food necessary to sus- 
tain life takes place in the intestine, and 
the balance or residue must be passed from 
the body. If there is weakness of the in- 
testinal muscles, or if there is an absence 
of intestinal glandular activity, the stool, 
instead of being soft, will be hard and dry, 
and will stagnate in the bowel. This stag- 
nation causes headache, besides a distention 
of the abdomen, 
causes Among the chief causes of constipation 

are insufficient exercise and dietetic errors. 
As a rule, mistakes in diet are responsible 
for 75 per cent of all cases of constipation. 

To provoke a regular movement of the 
bowels we must have a regular system of 
feeding. If a child has taken a meal, he 
must be given sufficient time before par- 
taking of the next meal to properly digest 

[120] 



IMPEOPEK tfUTKITION 

the previous meal. To overtax the stomach 
and overwork the glands weakens them, and 
consequently we overstrain the digestive 
tract by giving it more work than it can 
accomplish. Overeating and too frequent 
feeding, therefore, are the two chief causes 
of constipation. 

Cakes, pies, puddings, pastries, and mac- 
aroni may all be eaten in moderation. They 
are nutritious, but if potatoes and large 
quantities of starchy food and bread are 
consumed, they must be aided by exercise 
and water, otherwise constipation will re- 
sult. Many children will not take fruit, 
others eat too much candy, but such habits 
may not be permitted without detrimental 
result. Every child must eat vegetables, 
for their nutritious as well as laxative ac- 
tion. Kellogg's bran may be added to the 
cereals, or a teaspoonful of malt extract 
may be given with the food or after each 

[121] 



HEALTH-CAKE OF THE GKOWING CHILD 

meal. Graham or corn-bread, bran-muffin, 
oatmeal with cream, and peach, apple, or 
prune puree will all stimulate the action of 
the bowel. 

We should teach the child to use the toilet 
chair at a certain time of the day, prefer- 
ably after breakfast. By this means the 
mind will aid in stimulating the bowel. 

Diarrhea 

When a child has more than three stools 
a day, they usually assume a liquid char- 
acter. This is termed diarrhea. 

The stools may be yellow or green, or 
they may contain traces of blood. As a rule, 
diarrhea is caused by a derangement of the 
stomach and bowels. 

Among the most frequent causes is the 
eating of unripe or overripe fruit, improp- 
erly cooked, or partially decomposed foods, 
such as milk or fish that has not been kept 

[122] 



IMPEOPEE NUTEITION 

on the ice, ice-cold water, or ice-cream when 
the stomach is overheated. 

Disease germs present in any article of 
food will cause diarrhea. Water from a 
creek or pond, if polluted with sewage, will 
not only cause diarrhea, but may give rise 
to bloody stools (dysentery). 

From what has been said, we can see 
that diarrhea is usually caused by the in- 
troduction of disease germs in food which 
set up an inflammatory process in the stom- 
ach and intestine. This inflammation re- 
sults in the discharge of loose, watery, or 
mucous stools. There are other reasons 
for diarrhea ; for example, by plunging the 
feet in cold water and wading too long at 
the seashore, many children suffer with 
colic, and later on loose bowels. Many cases 
of diarrhea are preceded by colic or cramps 
in the abdomen. Besides the liquid stools, 
there is also a great deal of flatulence. As 

[123] 



HEALTH-CARE OF THE GROWING CHILD 

a rule, exhaustion and prostration follow 
loose bowels, and if the diarrhea continues 
longer than one day, the child should be 
kept quiet on the bed or couch, so that walk- 
ing and all exercise is avoided. Especially 
must the child be kept in bed if the tem- 
perature is over 100 degrees. 

In a neighborhood wherein typhoid fever 
has occurred, we should call a physician at 
the first sign of diarrhea, as typhoid fre- 
quently begins in this manner. 

Diarrhea is frequently brought on when 
the bulk of the food has been liquid rather 
than solid. If milk, soup, broth, tea, and 
orange juice have been consumed during the 
day, very little solid stool will be passed. 
If, on the other hand, bread, cake, potatoes, 
meat, and eggs were the chief articles of 
food, then liquid stools should not be ex- 
pected unless the food is of an irritating 
character or has stagnated in the intestines, 

[124] 



IMPEOPEE NUTEITION 

producing decomposition with gaseous fer- 
mentation resulting in explosive stools. 

In every case of diarrhea, whole milk Treatment 
should be stopped and skimmed milk given. 
Such skimmed milk must be boiled before 
using. Weak tea, rice steamed in water 
and flavored with cinnamon, farina, tapio- 
ca, and corn-starch pudding may be given. 
Arrowroot pudding is valuable, and toast 
made of stale bread may be given. Fresh 
bread should not be permitted. Mutton 
broth, thickened with rice or barley, is re- 
quired. Fruit should not be given. Water 
should be boiled and given sparingly. All 
vegetables excepting carrots may be given 
in moderation. 

A tablespoonful of castor-oil should be soda 

Injection 

given at the first sign of diarrhea. Two 
hours later the bowels should be washed 
with one quart of warm water, to which 
one heaping teaspoonful of bicarbonate of 

[125] 



HEALTH-CAKE OF THE GROWING CHILD 

soda has been added. When giving this in- 
jection the child should be placed on the 
left side and the irrigation given with the 
fountain- syringe held no higher than two 
feet over the child's body. By this means 
we avoid using too much pressure. 

One tablespoonful of lime-water should 
be added to each feeding of skimmed milk, 
so that two or three tablespoonfuls of lime- 
water may be given during the day. Give 
one teaspoonful of chalk mixture, well 
shaken, every hour for six doses, to a child 
of from five to fifteen years. If the diar- 
rhea does not improve after the above treat- 
ment a physician should be called. 

When a child has repeated attacks of 
diarrhea during the year, a subnormal 
condition exists, which can be improved by 
toning up the system. A tonic of iron may 
be required. 

[126] 



IMPROPER NUTRITION 

Colic or Cramps 

Cramps in the stomach and bowels are 
frequently caused by eating unripe fruit 
or food which is iced. Very fatty food is 
sometimes responsible for attacks of colic. 
These attacks consist of pain and rumbling 
in the abdomen due to gas. They are usu- 
ally followed by loose bowels. The dis- 
charges frequently contain mucus. The 
temperature of the child should be taken 
to see whether or not fever is present. At- 
tacks of colic, if following a meal of unripe 
fruit or too fatty food, require a tablespoon- 
ful of castor-oil to cleanse the intestinal 
tract. A pinch of calcined magnesia, in 
water, after each meal will frequently pre- 
vent recurring attacks. 

Immediate relief can be afforded by the 
application of a hot-water bag and by giv- 
ing one-half teacupful of warm water to 

which five drops of essence of peppermint 

■ [ 127 ] 



HEALTH-CAKE OF THE GKOWING CHILD 

have been added. An injection of one-half 
pint of warm camomile tea is soothing, and 
will aid in the expulsion of gas and undi- 
gested fecal matter. If an attack of colic 
occurs and we are sure it is not caused by 
an indiscretion of diet, a physician should 
be called to determine the origin of the 
same. 

Intestinal Indigestion 

In intestinal indigestion we find undi- 
gested particles of food in the stool. There 
is a loss of appetite. The child is languid, 
complains of headache, and sometimes of 
pain in the arms and legs. Overfed chil- 
dren, and those suffering repeated attacks 
of gastric and gastro-intestinal disorder, are 
more likely to have intestinal indigestion. 
As the food is not properly assimilated, the 
child passes a large quantity of undigested 
particles of food. This deprives the child 

[128] 



IMPEOPEK NUTKITION 

of strength and results in a lowering of 
the vitality. 

Long-continued attacks of intestinal in- 
digestion produce loss of weight. The blood 
being deprived of nutrition, shows anemia. 
Thus, children suffering with intestinal in- 
digestion are extremely pale. Their ears 
are yellowish- white, and there is an absence 
of the healthy ruddy color so natural to 
child-life. 

In addition to the feeding of improper cause 
food, both quantity and quality, there is 
usually bad hygiene at the bottom of the 
trouble. 

Children who are forced to study too hard 
and are deprived of exercise and open-air 
activities usually suffer with intestinal in- 
digestion. Oxygen is demanded for the nu- 
trition of the red-blood corpuscles, and if 
foul air in classrooms or in bedrooms is 
substituted for pure fresh air, the peptic 

[129] 



HEALTH-CAKE OF THE GKOWING CHILD 

glands and the intestinal glands being 
robbed of their vitality, can not perform 
their normal work, and as a result the food 
is deprived of secretions which are neces- 
sary for its digestion and assimilation. 
Treatment To modify this condition the following 

plan is suggested. If meat has been per- 
mitted, it should be minced and then thor- 
oughly masticated, so that saliva is incor- 
porated with the food. Children frequently 
bolt their food, and until this habit is 
broken they should have all their vegetables 
mashed. We can give puree of lima beans, 
winter beans, peas, and potatoes, so that 
large quantities of food do not enter the 
stomach. Coddled eggs, junket, pot-cheese, 
and custards may be permitted, whereas 
pies, cakes, and iced foods should be pro- 
hibited. Ice-cream and water-ice are espe- 
cially harmful if given immediately after 
a meal, as they interfere with digestion. 

[130] 



IMPKOPEK NUTRITION 

Medication especially intended for this 
condition must be ordered for each indi- 
vidual case by a physician. 

Rickets 

Rickets is a weakened or faulty condition 
of the bones and teeth caused by improper 
feeding or by poor assimilation of food. 
Faulty hygiene, resulting from want of 
fresh air, with closed windows at night, may 
cause rickets. Bolters who eat quickly, do 
not chew well, and digest badly, usually 
develop rickets. Rickets may affect the 
spine, the ribs, the arms, the legs, or the 
bones of the skull, so that any part of the 
body may show a structural weakness. 

The teeth are brittle, chalky, and decay 
easily. The muscles are flabby and lose 
their tone. It is for this reason that we 
usually have constipation present. Rachitic 
children are usually backward in talking 

[131] 



HEALTH-CARE OF THE GROWING CHILD 

land backward in walking. The soft bones 
yield on walking, thus causing bowlegs. 
These children are very susceptible to dis- 
eases. They have an especial tendency to 
adenoids and enlarged tonsils. A rachitic 
child should be hardened and protected, 
because of a tendency to tuberculosis in 
later life. 

To harden a child, in addition to hygienic 
measures previously described, necessitates 
giving it food which is easily assimilated. 
Food which will build the bones and 
strengthen the muscles. Cereals, such as 
oatmeal, cornmeal, wheatena, rice, and bar- 
ley, are bone-builders. Yolk of egg should 
be added to these cereals. Meat and vege- 
tables may be given liberally. Vegetables 
should be given twice a day. 

To assimilate food properly, children 
should be fed at regular intervals, with 
nothing between meals. If practicable and 

[132] 



IMPROPER NUTRITION" 

possible, the child should be permitted to 
sleep out of doors and hardened in this 
manner. Do not give cathartics continu- 
ously; they are weakening. Rely on diet, 
principally, to modify constipation. 

Weak Ankles 

Weak ankles are caused by weakness in 
the ligaments of the joints, or they may 
be an association of rickets in which soft 
bones and flabby muscles exist. Dyspeptic 
manifestations during infancy and child- 
hood lay the foundation for this condition. 

Exercise and proper diet will build up 
the ankles to a normal condition. Cereals, 
eggs, meat, and vegetables should form the 
principal part of the diet ; cakes, pies, and 
puddings should be given but sparingly. 

Children suffering with weak ankles 
should not be deprived of exercise such 
as roller-skating, ice-skating, or bicycle- 

[133] 



HEALTH-CAKE OF THE GKOWING CHILD 

riding. These exercises must, however, be 
taken in moderation, and at the first sign 
of fatigue or turning of the ankle, rest must 






Fig. 21. 



Fig. 22. 



Fig. 23. 



These illustrations, taken from Florence Bolton's 
Exercises for Women, published by Funk & Wagnalls 
Company, are well worth studying. 

Fig. 21. — A common sight — the ankles bulging in- 
ward under the weight of the body. 

Fig. 22.— A front view of Fig. 21. "Toeing out" 
has lengthened the inner line of the foot and allowed 
the bodyweight to fall to that side, pressing down the 
arch. 

Fig. 23. — A normal springy step. Notice that the 
weight falls on the outer side of the foot and that the 
line of action is straightforward. 

be enforced. The period between fatigue 
will gradually lengthen until the child can 
remain on skates or wheels an hour or 
longer. 

[134] 



IMPROPER NUTRITION 

Crooked or run-down heels are not al- 
ways a sign of weak ankles, but more fre- 
quently result from the faulty use or posi- 
tion of the feet in walking. 

Scurvy 

When children are deprived of fresh 
meat, fresh vegetables, and fresh milk, and 
fed on condensed milk and canned goods 
for a very long time, scurvy may result. 

The body requires a live factor which is 
present in raw milk and which disappears 
when the milk is boiled or preserved. 
Scurvy shows itself by spongy gums with 
tendency to bleed. The stools will be soft 
and frequently contain streaks of mucus 
and blood. There are tendencies to hemor- 
rhage in various parts of the body, due to 
frail blood-vessels. 

There is no danger in giving an occa- 
sional meal of canned or preserved food of 

[135] 



HEALTH-CAKE OF THE GKOWING CHILD 

standard quality, but if we deprive the child 
of all fresh foods, such as raw milk, orange 
juice, steak juice, and raw white of egg, 
scurvy may result. 

Cases of scurvy should always be placed 
under the treatment of a physician, as ad- 
vanced cases may have chronic symptoms 
which would pass unobserved by the aver- 
age mother. If properly treated, scurvy 
will leave no after-effects. 



[136] 



PART III 

CATARRHAL, COMMUNICABLE, AND 
SYSTEMIC DISEASES 



[137] 



Chapter I 

CATARRHAL DISEASES 

The Throat 

To examine the throat, we should take Normal 

Appearance of 

the child in a good light, near the window, the Throat 
and depress the tongue with the handle of 
a spoon. 

Hanging over the root of the tongue is 
the soft palate, and on either side of the 
palate we have the tonsils. These, if swol- 
len, are ragged, beanlike projections, pink- 
ish in color. 

The back of the throat, if healthy, pre- 
sents a pinkish color; this can always be 
distinguished from the bluish-red and dry 
appearance of the throat during an inflam- 
mation. 

It is a good plan to inspect the throat 

[139] 



HEALTH-CAKE OF THE GKOWING CHILD 

of a healthy child frequently, so as to fa- 
miliarize one's self with the appearance of 
the same in health, and at the same time 
teach the child not to fear the examination. 

The throat is the source of more trouble 
in the growing child than any other part 
of the body, therefore it pays to carefully 
inspect it many times in order to recognize 
patches or swellings when they occur. 

When a child refuses to eat, one of the 
first things to do is to inspect the throat, 
as all dust and disease germs are inhaled 
through the mouth and nose. When chil- 
dren are indisposed and appear languid, 
the mother should inspect the throat. She 
will be able to see the beginning of inflam- 
mation in the throat, if present, and can 
thereby locate the trouble very early. 

Loss of appetite is in many cases believed 
to be due to a spoiled stomach, when in 
reality an inflammation in the throat is re- 

[140] 



CATAEEHAL DISEASES 

sponsible for the trouble. Frequently chil- 
dren five to six years old, and sometimes 
eight to ten years old, may complain of 
headache, when the trouble really is in the 
tonsil. This is important to know, because 
fifty per cent of cases of fever in children 
begin with a sore throat and loss of ap- 
petite. 

Adenoids 

Adenoid vegetations are small wartlike 
masses varying in size from one-quarter to 
one inch in length. They are found at the 
back of the nose and throat. Their growth 
and enlargement depend on the presence 
of catarrh. 

Some children have a tendency to ade- 
noid formation. This tendency is found in 
the child with rickets, or with syphilis, and 
in the glandular type of child. 

In catarrhal families, where bronchitis, 
tonsillitis, and frequent colds and coughs 

[141] 



HEALTH-CAKE OF THE GKOWING CHILD 

are found, most if not all children develop 
adenoids. There are hundreds of children 
with small adenoids that go through life 
without any evidence of the same. But the 
presence of adenoids may be suspected if 
the child suffers with frequent attacks of 
running nose, loss of appetite, and restless- 
ness. 
Mouth The most important symptoms are 

Breathing 

mouth-breathing, snoring, and occasionally 
bed-wetting. If adenoids are permitted to 
grow, they can block the back of the nose 
so that they interfere with breathing ; there- 
fore, an adenoid child uses its mouth in- 
stead of its nose for respiration. Nature 
gave us the nose through which to breathe, 
but also to filter the dust from the air on 
its way to the throat. Many disease germs 
when inhaled through the nose are not as 
dangerous as when they enter through the 
mouth. 

[142] 



CATAEEHAL DISEASES 

Long-standing adenoids will produce a 
deformity of the npper jaw and push the 
jaw forward so that the upper teeth pro- 
trude far beyond the lower teeth. 

The nose has a peculiar pinched expres- 
sion, and physicians speak of the facial ex- 
pression as the "adenoid habitus.' ' That 
there is extreme danger in the nonremoval 
of adenoids can be seen by the fact that 
the majority of sufferers from scarlet fever, 
diphtheria, and recurring croup, are those 
in which enlarged tonsils and adenoid vege- 
tations are found. 

We can safely say that the presence of 
adenoids invites contagious diseases, be- 
cause adenoids as well as tonsils will har- 
bor disease germs, and give them a soil for 
their propagation. 

In addition to inviting disease, adenoids, Deafness 
if obstructing the Eustachian tube in the 
throat, can cause deafness. Such deafness 

[143] 









HEALTH-CARE OF THE GROWING CHILD 

can fortunately be cured by the removal 
of the adenoids. 

Adenoid vegetations are usually the re- 
sult of recurring colds in the head; they 
are, however, occasionally found in the 
newly born, so that pre-natal tendencies do 
exist. 

When adenoids exist in an otherwise 
healthy throat they may not give rise to 
any disturbing symptoms. When, on the 
other hand, the child suffers with fever or 
catarrh, then adenoids will swell, as they 
frequently do in damp weather, and give 
rise to symptoms. These symptoms are 
nasal obstruction, caused by catarrhal dis- 
charges, interference with breathing, and, 
at night, snoring. 

Adenoids Adenoid vegetations are frequently re- 

cause Bar 

Discharge sponsible for long-continued ear discharges. 
When a running ear will not yield to the 
routine methods of syringing and general 

[144] 



CATARRHAL DISEASES 

building up of the system, the cause may- 
be looked for somewhere in the vault of the 
pharynx. Very frequently the removal of 
a small adenoid growth will aid in stopping 
a discharging ear. 

Many cases of restlessness at night are 
due to the presence of adenoids. Many 
children are dosed with useless worm medi- 
cines when adenoids are the cause of the 
grinding teeth and insomnia. 

Every now and then a case of bed-wetting Bed-wettin g 
will be seen that is due to a reflex disturb- 
ance wherein adenoids are the cause. Pig- 
eon-breasted children have this deformity 
of the chest in many instances due to a 
long-delayed operation. 

The adenoids prevent the proper amount 
of fresh air reaching the lungs, and by thus 
interfering with the respirations, the de- 
formity of the chest is gradually developed 
until it remains permanent. 

[145] 



HEALTH-CAKE OF THE GKOWING CHILD 

From what has been said it will be seen 
that the presence of adenoids in a growing 
child is a great menace, the removal of the 
same a great benefit. 

In the public schools, teachers have long 
since recognized the association between 
mental backwardness and adenoids. The 
dullest pupils in the classroom are usu- 
ally sufferers from adenoids. These are 
the reasons why the health department of 
every large cosmopolitan city all over the 
country, also educators, recognize the dan- 
ger of adenoid vegetations among school- 
children, and have urged parents for years 
to have these growths removed. They in- 
terfere with both the physical and mental 
development of the child. 

Tonsillitis 

In this condition, when the throat is ex- 
amined, yellowish or yellowish-white dots, 

[146] 



CATARRHAL DISEASES 

pin-point or larger in size, and looking like 
droplets of cream, on one or both sides of 
the throat, will be seen. (See frontispiece.) 
There is always fever present. In the 
beginning it may be only 102 degrees, but 
later reach 103 or even 105 degrees. These 
fever attacks are accompanied by a tired 
feeling, with muscular pains and extreme 
thirst. ' Some children are drowsy and do 
not wish to be disturbed. The fever and the 
poison from the tonsils disturb the internal 
secretions, and constipation of a most ob- 
stinate character frequently accompanies 
the same. Headache and vomiting may also 
be present. The examination of the throat 
in addition to the spots above mentioned 
shows redness, and the parts will be dry and 
shiny. There is a sour odor to the breath. 
The tongue will be correspondingly dry. 
The physician should be called because of 
the danger of complications. 

[147] 



HEALTH-CAKE OF THE GKOWING CHILD 

Until the physician can he reached, one 
pint of soapwater should he injected into 
the howel. This will always reduce the tem- 
perature, relieve the headache, and brighten 
the child. 

To quench thirst, reduce the temperature, 
and stimulate the kidneys, a wineglassful 
of citrate of magnesia should he given every 
hour for six hours. 

It is a good plan to investigate the origin 
of every case of tonsillitis and find out at 
school or among friends if the child has 
been exposed to diphtheria. There are 
many points of difference in the two dis- 
eases which will be described in the chapter 
on diphtheria. 

Rhinitis, or Cold in the Head 

catarrh Rhinitis means catarrh in the head with 

running nose. Sneezing is usually present. 
As a rule, when children have frequent re- 

[148] 



CATAEEHAL DISEASES 

curring colds in the head, we find the throat 
to be the seat of the trouble. Adenoids 
concealed somewhere in the back of the nose 
will swell like a moistened sponge and give 
off a continuous discharge of a yellowish 
or yellowish- white color, or diseased tonsils 
will carry millions of germs. The condi- 
tion is found in children who are not in a 
normal state of health. When the body is 
weakened, the blood is thinner and the cir- 
culation is poorer. The hands and feet, in- 
stead of being warm, are cold. The slight- 
est chilling of the surface of the skin by 
changing to light clothing or thinner under- 
wear is usually followed by a running nose, 
or by sneezing, and symptoms commonly 
called a cold in the head. 

Active exercises followed by perspira- 
tion, unless properly checked, will result in 
a cold in the head. 

Recurring colds can be improved, but not 

[149] 



HEALTH-CAKE OF THE GROWING CHILD 

cured, by using sprays or inhalations, or 
any of the rhinitis drugs, such as aspirin, 
phenacetin, or salol. 

To cure this catarrh permanently, we 
must have the adenoids scraped away ; then 
the discharge will stop. 

A cold in the head, resembling rhinitis, 
with sneezing and coughing, may be the 
beginning of measles. It is safer to put 
the child to bed for one day, or until the 
nature of the cold is determined. Very fre- 
quently an innocent-looking catarrh in the 
head, with running nose, marks the begin- 
ning of diphtheria of the nose. 
Biood Test Syphilis, if the cause of rhinitis, can only 

be determined by an examination of the 
blood. If we are suspicious that catarrh is 
inherited from either parent, then a Was- 
sermann blood-test should be made — this 
will determine positively whether or no the 
child has a syphilitic catarrh. 

[150] 



CATARRHAL DISEASES 

Coughs 

A cough means an irritation. Phlegm in 
the back of the throat may cause a tickling 
and irritation until expectoration clears the 
same. Swollen tonsils or swollen adenoids 
give off a discharge which causes a cough. 
A cough due to adenoids or tonsils appears 
when the child lies on its back; therefore, 
a night cough is suggestive of the presence 
of adenoids. Not all night coughs, however, 
are caused by adenoids. In the beginning 
of a whooping-cough, before the whoop ap- 
pears, the child will cough mostly at night. 
The cough will also be stronger at night. 
The cough associated with whooping-cough, 
as also the cough due to adenoids, is not 
accompanied by fever. This point is im- 
portant to remember, especially when an 
irritating cough exists and continues for 
many weeks. 

The cough associated with influenza or the 

[151] 



HEALTH-CARE OF THE GROWING CHILD 
Due to cough associated with bronchitis is always 

Pleurisy ° J 

accompanied by fever. The fever may 
reach 100 degrees in the morning and 102 
degrees at night. A cough similar to a 
bronchial cough, but usually accompanied 
by pain on one or both sides of the chest, is 
due to pleurisy. The little patient will in- 
stinctively place his hand over the painful 
spot on the side of the chest to relieve the 
pain produced by coughing, and will always 
lie on the affected side. In pleurisy there is 
rarely any expectoration, but a great deal 
of cough. The cough caused by a continued 
bronchitis or pleurisy will, if prolonged, 
cause a loss in weight. I shall refer to the 
treatment of these coughs in the special 
articles pertaining to diseases later on. 

If the child has a cough and loses weight, 
and if there is fever accompanying the same, 
a physician should be called, so that the 
nature of the cough can be established. 

[152] 



CATARRHAL DISEASES 
Tuberculosis frequently has a cough and Due to 

x * ° Tuberculosis 

a slight fever which resembles pleurisy, and 
it would be very serious to neglect the 
beginning of a tuberculosis, because the 
chances of a cure are greater in the begin- 
ning of every disease. My advice, there- 
fore, is to consult a physician the moment 
a cough is accompanied by fever, until the 
true nature of the disease is established. 



[153] 



Chapter II 
COMMUNICABLE DISEASES 

how conta- Diphthekia, measles, and scarlet fever — 

gious Diseases 

are spread m f ac ^ a n contagious diseases — are spread 
by contact with discharges containing the 
germs. 

Convalescents who have living disease 

germs in the throat or nasal discharges can 
communicate the disease through these dis- 
charges. Ear discharges and vaginal dis- 
charges during the course of scarlet fever 
assume malignancy, and frequently trans- 
mit the disease thereby. 
"Carrier" The most frequent means of dissemina- 

tion of disease is through carriers. A ' ' car- 
rier' ' is a person who has had an infectious 
disease from which he is apparently cured, 
but who still carries the disease germs capa- 

[154] 



COMMUNICABLE DISEASES 

ble of transmitting such disease to healthy 
people. Many people may carry disease 
germs in their nose and throat for months 
after the active symptoms of the disease 
have subsided. 

To determine the existence of disease 
germs after convalescence from scarlet 
fever, and especially diphtheria, a culture 
should be taken from the discharges of the 
nose and throat. In suspected typhoid 
fever a culture taken from the stool will 
quickly determine the presence or absence 
of such disease germs. 

Another means of conveying the disease Direct 

Contact 

is by the fingers of a person nursing a pa- 
tient. Unless the nurse is instructed in the 
necessity of washing her fingers immedi- 
ately after each handling of the patient, 
she may be the means of carrying the dis- 
ease to healthy persons. If we permit a 
healthy child to drink from a glass or use 

[155] 



HEALTH-CAKE OF THE GKOWING CHILD 

a spoon immediately after a sick child has 
used it, disease germs can be directly con- 
veyed to the healthy child. This proves the 
necessity for keeping all utensils separated, 
and more especially the need of washing 
them before they are used by others. Cloth- 
ing should be thoroughly cleaned, under- 
Disinfection wear should be boiled and washed, and when 
thoroughly aired need not be feared. Dis- 
ease germs die quickly when exposed to the 
air. No one need fear contracting a con- 
tagious disease by using clothing after the 
same has been cleaned and aired. Chemi- 
cal disinfection of clothing and bedding has 
been abandoned. 

Insects, such as flies, mosquitoes, and 
Bugs, especially bedbugs, carry disease. 
These insects come in direct contact by 
crawling over the body, and so carry dis- 
ease germs directly from person to person. 
During illness all food should be carefully 

[156] 



COMMUNICABLE DISEASES 

covered to guard against insect contam- 
ination. Windows and doors should be 
screened to keep insects, and especially 
flies, out of the house. 

Affection bestowed by a kiss in the im- Kissing 
mediate family is not harmful, nor is it 
harmful providing we are sure that there 
is no one ill with influenza, diphtheria, or 
pneumonia, as these germs are found in 
the saliva. 

Indiscriminate kissing by the nursemaid 
and by strangers is always risky, and must 
be condemned. Our present knowledge of 
the contagion of disease, and the ease with 
which disease is communicated from mouth 
to mouth, should render thoughtful parents 
cautious in regard to kissing. 

Syphilis can be conveyed by an innocent 
kiss. We should prevent children, espe- 
cially at school, from getting the habit 
which some day may prove disastrous. 

[157] 



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[158] 



COMMUNICABLE DISEASES 

Influenza 

Influenza, commonly known as "grippe," 
is a frequent disorder of childhood. There 
are mild and severe types of influenza. It 
is our most frequent form of winter cold, 
and begins with a cold in the head, cough, 
fever, and ache or pain in the limbs. 

There is another form of influenza in Gastric Type 
which we have fever, loss of appetite, and 
either vomiting or diarrhea. This is the 
so-called gastric type which affects the 
stomach and bowels. 

A third form of influenza affects the nerv- 
ous system. There is fever and sometimes 
delirium or intense headache. The influenza 
bacillus causes either form of this disease. 
It enters the nose and throat, gets into the 
circulation, and produces the above-named 
symptoms. 

The most common type is the catarrhal catarrhal 

Type 

form, which has a tendency to spread from 

[159] 



HEALTH-CAKE OF THE GKOWING CHILD 

the nose and throat into the bronchial tubes, 
setting up either a bronchitis, a pleurisy, 
or a pneumonia. 

An influenzal pneumonia is a long-drawn- 
out affection in which the pneumonia does 
not terminate by crisis in seven to nine days, 
but lasts two to four weeks. Owing to the 
length of time this disease lasts, there is 
considerable loss of vitality and exhaustion 
resulting therefrom. Another disagreeable 
form of this catarrhal type is the spread of 
the influenza bacillus into the ear-passages. 
In some cases there will develop an ear 
abscess, in other cases the influenza bacillus 
penetrates the mastoid cells, behind the ear, 
giving rise to mastoid inflammation. While 
mastoid inflammation is not a fatal disease, 
it should always be regarded as a serious 
complication. 

If a child contracts influenza from another 
member of the family, and has fever (a tem- 

[160] 



COMMUNICABLE DISEASES 

perature of over 100 degrees), it should be 
put to bed, given a mustard foot-bath and 
a laxative. One grain cascara tablet, re- 
peated in four hours if not effectual. After „ 
the bowels are cleansed, one grain of salol 
may be given three times a day. If the 
fever does not subside within twenty-four 
hours, call a physician. 

Bronchitis 

Bronchitis is a catarrhal affection of the 
bronchial tubes, and begins with a cold in 
the head. The air-tubes in the upper por- 
tion of the lungs are very susceptible to 
catarrhal inflammation. Catarrh germs 
enter the nose and throat and set up an 
inflammation which extends from the throat 
downward to the bronchial tubes. There is 
usually a slight rise in the temperature, the 
fever will range between 100 degrees in the Fever 
morning and 102 degrees in the evening. If 

[161] 



HEALTH-CAKE OF THE GROWING CHILD 



Neglected 
Cases 



Treatment 



the bronchitis is associated with influenza 
the duration may be several weeks. Bron- 
chitis should not be neglected. Unless the 
bodily strength is restored with the aid of 
tonics, loss of weight may occur. In many 
cases the tendency to ignore a bronchitis 
and to trust to nature should be condemned. 

Neglected cases of bronchitis lay the 
foundation for repeated attacks, and result 
in chronic bronchitis. Neglected cases are 
also a favorable soil for the development 
of tuberculosis, and this is really what we 
must guard against. 

Bronchitis is usually associated with 
measles; it may also follow influenza. No 
matter how mild the case, it is better to 
have the lungs carefully examined by a phy- 
sician and have a correct plan of treatment 
outlined. 

There is a vast difference in treating a 
case of bronchitis in the city or in the coun- 

[162] 



COMMUNICABLE DISEASES 

try. Dust and dirt and changeable climate 
are factors that provoke irritation and keep 
up an active bronchial catarrh. It is there- 
fore advisable to change from the city to 
the country, preferably to a higher altitude. 
An altitude of 1,000 to 1,500 feet, for sev- 
eral weeks, will relieve the catarrhal inflam- 
mation of a bronchitis, besides giving the 
child a better appetite and aiding in the 
digestion of food. 

Sleep is an important factor, and the dis- 
turbance of sleep caused by continued cough- 
ing should be remedied. Antispasmodics, 
such as belladonna, will soothe the mucous 
membrane, dry the secretions, and thereby 
promote sleep. It is self-understood that 
all drugs must be ordered by a physician. 

If a cough-mixture or an inhalation is or- 
dered, and the child happens to fall asleep, 
do not disturb it — wait until it awakens. 
The habit of rousing a child out of a sound 

[163] 



HEALTH-CARE OF THE GROWING CHILD 

sleep is vicious and cannot be too strongly 
condemned. Nature demands sleep to re- 
pair waste, and it may be necessary to give 
small doses of drugs to assist nature now 
and then in promoting sleep. This applies 
to sick children only. 

Bronchial Asthma 

Eecurring attacks of bronchitis, with 
wheezing heard over the front and the back 
of the chest, are known as bronchial asth- 
ma. One of the reasons for this wheezing 
and difficulty in breathing is due to a swell- 
ing of the inside lining of the bronchial 
tubes. This swelling renders the entrance 
of air more difficult ; as a result there is an 
wheezing imperfect oxygenation of the lungs. The 
blood suffering from this loss of oxygen 
is shown in a bluish color of the body, espe- 
cially of the lips and finger-nails. There 
is cough and difficulty in breathing, but lit- 

[164] 



COMMUNICABLE DISEASES 

tie or no expectoration. As a rule, there 
is a slight fever, but rarely higher than 
from 100 to 101 degrees. 

These attacks of asthma usually owe 
their origin to some albuminous food which 
causes this disturbance, resulting in spas- 
modic attacks of the bronchial tubes. 

Some children will have recurring asth- 
matic attacks after eating eggs. Other 
children have a sensitive reaction to cere- 
als. If once the reason for the attack has 
been definitely determined, the recurrence 
of the same can be avoided. 

We do not look upon asthma as due to 
a cold, although chilling the surface of the 
body when overheated will render sensitive 
children more liable to attacks. 

For the relief of bronchial asthma, cup- 
ping of the chest is beneficial. The bowels 
should be kept loose. Kitchen odors and 
tobacco smoke must be avoided. 

[165] 



HEALTH-CAKE OF THE GKOWING CHILD 

Fresh air is of prime importance. The 
windows must be open night and day, sum- 
mer and winter. During the attacks, no 
solid food should be given. Small doses 
of calomel will relieve the congestion of the 
liver and the lungs, and may be given in 
doses of one-tenth grain every ten min- 
utes for ten doses, after which a teaspoon- 
ful of rhubarb and soda mixture may be 
given every hour for three doses. 

Pneumonia 
Broncho- There are three kinds of pneumonia — 

pneumonia 

bronchopneumonia, lobar pneumonia, and 
tuberculous pneumonia. 

During the winter months, a cold in the 
head or influenza may last several weeks. 
The body loses strength, and there is a con- 
tinued fever. If the child is not kept in bed 
until the fever subsides, the influenza ba- 
cillus or the pneumonia bacillus will extend 

[166] 



COMMUNICABLE DISEASES 

from the nose and throat to the bronchial 
tubes, terminating in bronchopneumonia. 

Bronchopneumonia usually follows mea- 
sles, scarlet fever, or diphtheria. It is 
therefore the form of pneumonia that asso- 
ciates itself with an already weakened sys- 
tem. There is consequently a certain ele- 
ment of danger in this form of pneumonia. 

The condition usually lasts several weeks, 
but it may last months. It does not ter- 
minate by a crisis, as does lobar pneumonia, 
which will be described later. The tem- 
perature may range between 100 and 101 
degrees in the morning to 104 or even 105 
degrees in the evening. There is cough of 
a distressing character. There is very little 
expectoration. The appetite is poor, the 
bowels sluggish. The child perspires free- 
ly. There is loss of weight, due to the 
catarrh, the continuous fever, and lack of 
assimilation of nutrition. 

[167] 



HEALTH-CARE OF THE GROWING CHILD 

In some cases the disease may extend 
from one portion of the lung to another. 
Not infrequently both lungs may be in- 
volved, so that bronchopneumonia will be 
found on both sides of the chest, and in the 
upper as well as the lower lobes. 

The outcome of a case of bronchopneu- 
monia depends on the amount of lung in- 
flamed. It also depends on whether or no 
the child has rickets. The exhaustion due 
to the prolonged fever demands not only 
Alcoholic concentrated food, but also stimulation. 

Stimulation 

The heart must be strengthened during the 
course of the disease. In many cases it is 
imperative to add whisky to the milk and 
egg to stimulate the circulation. Parents 
should never object to the use of alcoholic 
stimulation when ordered by a physician, 
for thereby the life of the child may be 
saved. 

The treatment of this disease requires 

[168] 



COMMUNICABLE DISEASES 

the careful judgment of a physician, and 
no mother or nurse should undertake the 
responsibility of treating the child without 
the supervision of a physician, 

The danger-point in bronchopneumonia 
consists in the weakness which may follow 
continuous fever, and this is first shown by 
the weakness of the heart action. The heart 
therefore needs watching. Such cases oc- 
casionally terminate in lung abscess, and 
where rickets exist, bronchopneumonia may 
terminate in tuberculosis. To prevent such 
complication the physician must pilot the 
case carefully from the beginning. 

As to the open-air method of treatment, coidAir 

Treatment 

children of robust constitution can tolerate 
cold air treatment. If, however, the circu- 
lation is poor, extremities cold, fingers, toes, 
and face bluish instead of pink, then warmth 
will do more good than the open-air treat- 
ment. Cold air exhilarates many children, 

[169] 



HEALTH-CARE OF THE GROWING CHILD 



Lobar 
Pneumonia 



but it depresses those whose circulation is 
poor, and especially children heretofore un- 
accustomed to it. 

Lobar pneumonia receives its name from 
the fact that one portion or lobe of the lung 
is inflamed. It usually is found associated 
with influenza, or mid-winter bronchitis. 

A sudden chill, followed by a very high 
temperature, such as 103 to 105 degrees, 
marks the beginning of an attack. Children 
complain of pain on breathing, of a stitch 
in the side. There is marked shortness of 
breath, considerable cough, but rarely much 
Expectoration expectoration. If there is any expectora- 
tion, it is of a reddish or brownish color, 
and is known as i ' prune- juice ' ' expectora- 
tion. This form of expectoration is char- 
acteristic of this type of pneumonia, and 
usually lasts from four to seven days, rarely 
longer. 

Just as we have a sudden rise in temper- 

[170] 



COMMUNICABLE DISEASES 

ature at the beginning of this disease, so 
do we have a characteristic drop from 105 
degrees to normal, between the seventh and 
ninth days of the illness. This is known 
as the ' ' crisis. ' ' When this crisis occurs the crisis 
child must be carefully protected against 
exposure. We must not believe that, be- 
cause the temperature is normal, all will go 
well. The heart-action and the pulse are 
better guides in estimating the true condi- 
tion of the child. 

Long after the physician has discontinued 
treatment the mother or nurse should re- 
member the severe strain to which the heart 
has been subjected, and if possible the child 
should be taken to the mountains or seashore 
for a change of air which will strengthen 
the lungs. 

Exercise which tends to exhaustion must 
not be permitted. 

Lung gymnastics by deep inspiration and 

[171] 



HEALTH-CARE OF THE GROWING CHILD 



Lung 
Gymnastics 



Tuberculous 
Pneumonia 



expiration should be ordered every morning 
and evening. At least a dozen long breaths 
should be taken, and this should be done 
after thorough ventilation of the room. 
This exercise will not only develop the lung 
but will give the blood more oxygen. It is 
therefore like giving a lung-tonic. 

Tuberculous pneumonia is a form of 
chronic inflammation in the lung in which 
there is associated tuberculosis. Children 
with pigeon-breast and flat chest, especially 
those with enlarged glands possessing very 
little vitality, are more liable to develop this 
form of pneumonia than robust children of 
good chest and lung development. 

When whooping-cough is neglected, and 
is a long-drawn out disease, we occasionally 
have tuberculous pneumonia as a complica- 
tion. When tuberculosis exists in a family 
and there is carelessness with expectora- 
tion, or kissing by a tuberculous father or 

[172] 



COMMUNICABLE DISEASES 

mother, or if milk from a diseased (tuber- 
culous) cow is fed, the tuberculosis germ 
can be carried into the body and thus set 
up tuberculous pneumonia. 

A child having tuberculous pneumonia 
has no chance to recover in a crowded city. 
It must be removed to the country for open- 
air treatment. Many of these cases offer 
little hope if the disease has progressed 
many months, with continuous loss of 
weight. Our only hope lies in giving such 
a child tonic treatment, such as arsenic or 
nux vomica to restore tone to the digestive 
tract, in addition to an outdoor life. 

Tuberculosis 

Tuberculosis is a disease caused by the 
tubercle-bacillus which enters the mouth or 
nose by inhalation or by means of food. If 
the food contains the tubercle-bacillus the 
intestinal type of tuberculosis usually de- 

[173] 



HEALTH-CAKE OF THE GROWING CHILD 

velops. In some cases the germs lodge in 
the back of the throat and penetrate the 
glands of the neck, causing glandular tuber- 
culosis. 

Milk and butter are frequently the vehi- 
cles that convey tuberculosis-germs; this 
applies to raw milk only. For this very 
reason physicians have for years advised 
the pasteurization or sterilization of milk, 
because by this means disease-germs are 
killed. When certified milk from inspected 
cows is received we are dealing with safe 
milk, and such milk only may be consumed 
in its raw state. What has previously been 
mentioned concerning the danger of ordi- 
nary market-milk applies to milk of un- 
known dairies. In such dairies if a milker 
has tuberculosis he can convey, by cough- 
ing, thousands of tuberculosis-germs to the 
milk. Another danger is that of the cow 
itself. The disease known as bovine tuber- 

[174] 



COMMUNICABLE DISEASES 
culosis is very common among cows, and if Bovine 

Tuberculosis 

the udder is diseased the milk is contami- 
nated during the milking process. Ulcers 
and discharges in and around the udder are 
a source of danger to milk. 

In a debilitated child, such as one that 
is weakened from a prolonged attack of 
whooping-cough, chronic bronchitis, pneu- 
monia, or pleurisy, the danger of develop- 
ing tuberculosis is readily understood. If 
the body is weakened it becomes a suitable 
soil for the development of the seed more 
easily than if the body is strong and healthy. 

Tuberculosis in childhood is curable pro- Giand 

Tuberculosis 

vided strict attention is given to modern 
methods of treatment. The treatment of 
gland-tuberculosis as well as the treatment 
of bone-tuberculosis consists in the surgical 
removal of the affected glands or bone. Do 
not misunderstand me. All gland- or bone- 
cases do not need surgical treatment. Many 

[175] 



HEALTH-CARE OF THE GROWING CHILD 



Heliotherapy 



Dietetic 
Treatment 



of these cases can, with excellent hygiene 
and good food, be bnilt np so as to throw off 
the disease and regain perfect health. The 
most important part of the treatment con- 
sists in giving the patient the benefit of 
heliotherapy. This consists in living per- 
manently at a slight altitude in the moun- 
tains and having windows open night and 
day, and exposing the body to the sun's 
rays. If it is not feasible to remove the 
child from its home to the mountains for 
the above outlined treatment, the next best 
thing is to take it to the seashore where the 
same plan of outdoor life, sun-baths, and 
in selected cases, sea-baths may be given. 

Milk with yolk of egg y buttermilk, cheese, 
vegetables, meat, and fruits should form the 
bulk of the diet. Whereas an interval of 
five hours between meals should be allowed, 
a glass of milk, cocoa, or malted milk may 
be permitted between meals. 

[176] 



COMMUNICABLE DISEASES 

Chronic bronchial coughs, especially if 
the body loses weight, should be regarded 
with suspicion. If fever is present in the 
evening and the child perspires, the sputum 
should be examined for the presence of the 
tubercle-bacillus. Many diseases have symp- 
toms similar to tuberculosis. In malarial Empyema 
fever the symptoms resemble those of tuber- 
culosis, but the blood-test can determine the 
presence or absence of the malarial germ. 

An abscess in the lung, so-called empy- 
ema, gives symptoms similar to tuberculo- 
sis. Because of the similarity of symptoms 
in various diseases and the difficulty in iden- 
tifying tuberculosis, when no expectoration 
is present, we are compelled at times to 
wait several weeks until a positive diagnosis 
can be made. If expectoration is present, 
the presence of the tubercle-bacillus in the 
same will complete the diagnosis. 

The diagnosis of brain-tuberculosis is 

[177] 



HEALTH-CAKE OF THE GROWING CHILD 



Brain- 
Tuberculosis 



Treatment 



most easily made by drawing off a small 
quantity of the spinal fluid and testing 
the same for the presence of the tubercle- 
bacillus. 

Many years ago tuberculosis was re- 
garded as a fatal disease, and every patient 
who suffered with tuberculosis was re- 
garded as doomed. Modern science has 
recognized the necessity of taking all cases 
of tuberculosis out of their bedrooms and 
warm blankets and placing them in ham- 
mocks or open-air shacks, or on balconies 
and giving them a liberal supply of fresh 
air and sunlight. The sun's rays are the 
best disinfectants. This is recognized by 
the various Health Departments who, in- 
stead of using formalin and sulfur disin- 
fection, now resort to fresh air and sunlight 
to kill germs. Sirups, foul-smelling creo- 
sote, and carbolic sprays to disinfect the 
air-passages have been discarded as useless. 

[178] 



COMMUNICABLE DISEASES 

The treatment now consists in disinfecting 
the lungs with continuous fresh air, placing 
the patient in a sun-bath, keeping the skin, 
bowels, and kidneys free, clean, and active, 
aiding nature by restoring the lost vitality 
with concentrated foods and following this 
up with tonics such as arsenic, iron, cod- 
liver-oil or butter and cream. 

In order to develop the lungs, lung-gym- Lung 
nasties, consisting of deep breathing to 
exercise both inspiration and expiration 
twice a day, five minutes each time, will 
expand the collapsed portions of the lung, 
bring fresh air into these darkened spaces, 
and also aid in throwing of! accumulated 
secretions. 

We can easily combine some pleasure 
with lung development in young children 
by having them blow soap-bubbles or col- 
ored liquid from one bottle into another by 
means of tubes. This will expand the air- 

[179] 



HEALTH-CAKE OF THE GKOWING CHILD 

cells in the lungs. In older children a com- 
bination of music with lung gymnastics can 
be obtained by having the child take lessons 
in cornet or flute playing. 

Whooping-Cough 

Whooping-cough usually develops in from 
two to seven days after exposure. The first 
symptoms are those of an ordinary cold, 
with a cough. This lasts about ten days, 
when the cough gets stronger until a pro- 
nounced spasm appears. These spasms 
consist of a number of short quick coughs, 
then a long-drawn inspiration known as 
"the whoop.' ' During these coughing 
spasms the child will get very red, some- 
times bluish-red in the face. The spasm 
usually ends with a vomit. It will be no- 
ticed that the cough is worse indoors and 
is least troublesome out-of-doors. The 
spasms are strongest at night. This is 

[180] 



COMMUNICABLE DISEASES 

usually so because the windows are shut. 
Fresh air night and day is very necessary 
for a cure. 

The danger in whooping-cough consists 
of exhaustion following lack of food as a 
result of the constant vomiting. The ex- 
haustion from the spasms of cough, espe- 
cially at night, rob the system of vitality. 
Loss of sleep due to the coughing parox- 
ysms is another element of danger. Nose- 
bleed is frequently provoked by a coughing 
spasm. Eupture in the groin or of the 
navel may be caused by the violent cough. 
Neglected whooping-cough extending over 
months may be the foundation for tubercu- 
losis in later life. 

It is better to know the dangers that 
threaten the patient and guard against 
them. No mother should undertake the 
management of a case of whooping-cough 
without consulting her physician. 

[181] 



HEALTH-CAKE OF THE GROWING CHILD 

An old superstition is mentioned merely 
to be condemned, namely: do not irritate 
the child's respiratory tract by taking it 
to a gas-house to inhale gas-fumes, 
isolation The child should not be permitted at 

school or at play with a healthy child until 
the cough has entirely ceased. This may 
be two months after the beginning of the 
disease, or it may be four months. It is 
better to safeguard a whole classroom 
rather than expose it to the danger of con- 
tracting whooping-cough. 

The duration of the disease is from eight 
to fourteen weeks. If the disease is neg- 
lected the symptoms or the cough may 
continue several months. 

Relief can be afforded during the violent 
coughing spasms by applying a tight muslin 
or linen binder around the chest, just as a 
mother applies an abdominal binder over 
the abdomen of her infant. This binder 

[182] 



COMMUNICABLE DISEASES 

should be changed every morning and even- 
ing. Relief can also be given by having the 
physician apply a plaster support over the 
ribs, just as is done in pleurisy. Strips of 
ordinary adhesive plaster applied over the 
ribs is best suited for this purpose. The 
plaster is to be changed every week. Opi- 
ates and drugs to cut short the spasms 
should be used only under the direction of 
a physician. Bitter almond water in two 
drop doses may be given every three hours 
to relieve the cough. 

When once the spasms are lessened in 
intensity and frequency, tonics such as iron, 
olive-oil or codliver-oil will aid in restoring Diet 
strength to the body. Milk with seltzer, 
buttermilk, yolk of egg with lemon-juice, 
malted milk, cocoa, or chocolate, ice-cream, 
junket, custard, corn-starch, or tapioca pud- 
ding and raw scraped steak are a few of the 
foods to be given to strengthen the child 

[183] 



HEALTH-CARE OF THE GROWING CHILD 

during the active process of the cough and 
when the same declines. 

Mumps 

Mumps consist of glandular swellings 
below the ears, under the jaw. After expo- 
sure mumps develops in one to three weeks. 

There is pain on chewing or opening the 
mouth and on swallowing. The tempera- 
ture is rarely higher than 101 degrees. An 
ice-bag, applied for four or five days, will 
reduce the swelling and cut the disease 
short provided there is no tonsil- or ear- 
complication present. 

The bowels should be kept loose. Liquid 
food must be sipped. The child should re- 
main in bed until all swelling has subsided. 
In some instances too much rubbing of the 
glands with massage or useless salves may 
develop an inflammation terminating in an 
abscess. 

[184] 



COMMUNICABLE DISEASES 

Croup 

There are two kinds of croup, one called 
false croup, the other true or diphtheritic 
croup. 

False croup comes on suddenly and usu- False croup 
ally at night. The child awakens out of a 
sound sleep with a barking, hoarse cough. 
The breathing is usually very noisy when 
the breath is being drawn in, and the child 
appears to suffocate. As a rule the croupy 
cough is so distressing that the children sit 
up so that they can breathe easier. Perspi- 
ration usually covers the face. The temper- 
ature will rarely be higher than 101 degrees. 
These cases occur in children who have 
gone to school during the day and have 
retired in apparent good health. The at- 
tacks subside by day and may recur several 
nights in succession. Such children may 
be classed as of the catarrhal type, subject 
to colds and coughs. Not infrequently they 

[185] 



HEALTH-CAKE OF THE GROWING CHILD 

suffer with rickets, bronchitis, or wheezing, 
and the frail condition renders them more 
susceptible to croup. 
Emetic Relief can be afforded by giving a tea- 

spoonful of sirup of ipecac, repeated every 
fifteen minutes if necessary, until vomiting 
is produced. For a child under four years 
of age give one-half the dose. If the accu- 
mulation in the throat is thick and gummy, 
let the child inhale steam from a tea-kettle 
or croup-kettle containing one teaspoonful 
of compound tincture of benzoin or spirits 
of turpentine to a pint of water. If after 
vomiting the child is not relieved, a warm, 
moist, flaxseed poultice with camphorated 
oil should be applied to the neck under the 
chin. Unless the attack subsides promptly, 
a physician should be called so that we may 
be sure the child is suffering from a catar- 
rhal or false croup and not from true mem- 
branous or diphtheritic croup. 

[186] 



COMMUNICABLE DISEASES 

In all diseases affecting the air-passages 
great relief will be afforded by opening tbe 
windows and allowing plenty of fresh air. 
Do not permit more than one person in the 
room with a croupy patient. By poisoning 
the air which occurs when several people 
are in the room, we indirectly do harm to a 
croupy sufferer. The patient should be 
isolated. All children and adults should be 
excluded from the room. 

After the attack of false croup subsides 
a tonic for the general system will restore 
tone and may prevent future attacks. 

True, Membranous, or Diphtheritic Croup 

This form of croup is very serious. It 
comes on gradually and the symptoms in- 
crease from day to day. The fever rises 
gradually. The glands of the neck become 
swollen. The croupy cough increases in 
severity from hour to hour. The breathing 

[187] 



HEALTH-CAKE OF THE GROWING CHILD 

wheezing will be labored and noisy. Wheezing sounds 
on inspiration can be heard in an adjoining 
room. Such labored breathing will compel 
the child to sit np and gasp for air. The 
face will lose its pinkish color and become 
bluish. The child looks distressed. The 
cough is short and barking with no expec- 
toration. The throat is filled with a thick 
membranous mucus which is the cause of 
the trouble. 

On examination of the throat we will not 
see yellowish- white spots or dots as we 
see in diphtheria, because these spots are 
so low in the throat that they can be seen 
only with the aid of a laryngeal mirror. 

Until a physician can be called, a tea- 
spoonful of ipecac mixed with a teaspoon- 
ful of glycerin may be given. In many 
cases vomiting will occur, but it is not es- 
sential to produce vomiting. If the croup 
gets worse, relief can only be given by 

[188] 



4 

COMMUNICABLE DISEASES 

inserting a tube through the mouth into Tube 
the larynx. This process is called intuba- 
tion. Some relief will be afforded by ap- 
plying a warm flaxseed poultice, to which 
camphorated oil or mustard is added, to 
the neck. Isolate the child from all others. Antitoxin 
Antitoxin should be injected as early as 
possible. There is great danger of delay- 
ing the injection of antitoxin in suspicious 
cases. Even though a case of croup does 
not prove to be real diphtheria, no harm 
can be done by the injection of antitoxin. 

As a rule, it takes from twelve to twenty- 
four hours to determine whether or no a 
case is diphtheria. The physician or nurse 
can take a smear from a suspicious throat 
and send it to a laboratory to have deter- 
mined whether or no the Klebs-Loeffler ba- 
cillus which causes diphtheria is present. 

Antitoxin destroys the poison or toxin 
given off by the diphtheria germs. To pre- 

[189] 



HEALTH-CARE OF THE GROWING CHILD 

vent complications such as paralysis or 
kidney disease, or in fact any complicating 
disease, antitoxin should be injected. The 
earlier it is used the surer are we of avoid- 
ing fatalities. It is too late to argue for 
or against antitoxin after death has oc- 
curred. 

Diphtheria is robbed of its terrors by 
using antitoxin as soon as we see symptoms 
which point toward the beginning of diph- 
theria. 

Diphtheria 

Diphtheria first appears as yellowish or 
yellowish-gray spots or patches. They are 
seen on one or both tonsils, behind the ton- 
sils on the pharynx, or sometimes in the 
nose. As a rule, the temperature rises, 
and the glands below the jaw become swol- 
len. There may be pain on swallowing. 
The appetite is poor. Thirst becomes in- 

[190] 



COMMUNICABLE DISEASES 

tense. The bowels are sluggish, as a rule 
constipated. 

I have previously called attention to the 
necessity of examining the throat of every 
child that feels sick. We may be surprised 
to find that a child with no appetite and 
some fever will not complain of its throat, 
but examination of the throat will reveal the 
true nature of the trouble. Any spots visi- 
ble in the throat demand medical attention. 
While many cases of tonsillitis are mild, 
we must not run the risk of neglecting a 
true case of diphtheria. 

The complication of the poisons given off 
by the germs of diphtheria may cause pa- 
ralysis or a weak heart. This can all be 
prevented if an injection of antitoxin is 
given as soon as the disease is detected, 
thus preventing the poison of the germs 
from doing serious damage. 

Antitoxin is a specific serum which, when 

[191] 



HEALTH-CARE OF THE GROWING CHILD 



Antitoxin 



Isolation and 
Disinfection 



used early, in proper dosage, prevents com- 
plications. There are two doses, one for 
healing purposes and the other used as a 
preventative of diphtheria, the so-called 
immunizing dose. 

When it is known that children have been 
exposed to diphtheria they should be pro- 
tected with an immunizing dose of antitoxin 
rather than run the risk of having them 
contract the disease. A child exposed to 
diphtheria, if infected, usually shows the 
first symptoms three to ten days after such 
exposure. 

A case of diphtheria should be isolated 
from all other healthy members of the fam- 
ily, and remain isolated until all symptoms 
of the disease have subsided. A convales- 
cent case should not be permitted to mingle 
with other children until a culture taken 
from the throat shows the absence of the 

diphtheria bacillus. 

[ 192 ] 



COMMUNICABLE DISEASES 

Our views concerning disinfection have 
changed considerably during the past few 
years. It has recently been proven that 
sunlight and fresh air will kill more germs 
than strong disinfectants. Most of our 
health departments have recognized the 
uselessness of disinfecting with chemicals, 
and have abandoned the same, using sun- 
light, fresh air, and scrubbing with soap and 
water. In New York we use no other disin- 
fection after diphtheria and measles. 

The Health Department requires that 
each apartment in which a communicable 
disease existed shall, on the termination 
of the same, be thoroughly scrubbed and 
freshly painted. If the rooms are papered, 
the same should be scraped from the walls, 
and fresh paper applied. 



[193] 



HEALTH-CARE OF THE GROWING CHILD 

Chicken-Pox 

The eruption consists of elevated pustules 
filled with a yellowish serum. It is an in- 
fectious disease, usually contracted by di- 

The Eruption rect exposure. A child who has been ex- 
posed usually contracts the disease within 
two to three weeks after such exposure. 

A rash of small pink papulae is first seen 
on the face, scalp, or back, and quickly 
spreads to the abdomen. These papulae soon 
become elevated pustules filled with a yel- 
lowish serum. The Germans call the dis- 
ease "Wasser pocken," because they re- 
semble water-blisters. In a few days these 
pustules dry up and crusts form, which 
drop off within a week or two. The erup- 
tion appears in crops. While some of the 
pustules are drying up, others are just be- 
ginning to appear. 

Fever As a rule, the temperature does not go 

above 101 degrees. 

[194] 







CHICKEN-POX 

For description see text. 



i 



rr >F THE GROW 

Chicken-Pox 

Th on consists o I ted pustn 

filled owish serum. It is an in- 

. usually contracted by di- 
The BrUF k child who has been ex- 

tracts the o within 

ks after su< osure. 

mall pink papulae is first seen 
scalp, or back, and quickly 
abdomen. These papulae soon 

xoJ.i«SJSte5 filled ™ ih a yel " 

x-^^^feen^Piflans call the dis- 
■r pocken," because they re- 
r-blisters. In a few days these 
v up and crusts form, v 

ek or 
s in crops. While s« 
drying up, other 
pear. 
Fever the temperatu go 






COMMUNICABLE DISEASES 

Chicken-pox has no association with 
smallpox, and will appear in either a vac- 
cinated or unvaccinated child. It is the 
mildest eruption in childhood, and need oc- 
casion no alarm. Complications never oc- 
cur. To guard against having the evidence 
of pox later on, the child should be warned 
against scratching the crusts. Alcohol, in 
which a few grains of menthol have been 
dissolved, stops the itching, if applied every 
few hours. 

No solid food should be permitted during 
the first few days of the eruption. The 
bowels should be kept loose with the aid 
of a wineglassful of citrate of magnesia 
twice a day. Cases of chicken-pox should isolation 
be separated from healthy children for at 
least two to three weeks, or until all crusts 
have dried and fallen off. 



[195] 



HEALTH-CARE OF THE GROWING CHILD 

Measles 

Measles is most frequently found in chil- 
dren between the third and seventh year. 
It is very contagious. Measles poison 
travels upward like smoke. As a rule, the 
child on the fourth floor will contract the 
disease from the child on the third floor. 
The children on the lower floors, however, 
usually escape. Congested apartments, 
crowded houses, asylums, institutions, and 
the steerage of ships breed measles. It 
takes from seven to fourteen days for the 
disease to develop after the child has 
been exposed. Measles is most contagious 
one or two days before, and about three 
days after, the eruption appears on the 
body. 

The first symptoms of measles are a slight 
fever, and symptoms resembling cold in the 
head, with sneezing, coughing, and running 
nose. The appetite will be poor and thirst 

[196] 



COMMUNICABLE DISEASES 

excessive. The eyes will be dull and the 
child appears languid. 

Generally on the fourth day the rash is The Rash 
seen, first on the face which appears quite 
swollen, then on the neck, from where it 
spreads rapidly all over the body. The rash 
is bright red and appears in blotches with 
little crescent-shaped areas of white skin 
between the blotches. The rash remains 
at its .height about three days, when it be- 
gins to fade. In some cases the skin peels Desquamation 
off in fine flakes or scales. 

Several days before the eruption appears 
there will be restlessness and peevishness; 
the child will be tired and desire rest. 

The temperature before the eruption 
ranges between 100 and 101 degrees in the 
morning, reaching 102 degrees in the even- 
ing. During the succeeding three or four 
days the temperature may remain about Fever 
the same, but will suddenly rise to about 

[197] 



HEALTH-CAKE OF THE GKOWING CHILD 

103 or 104 degrees. About the same time 
a generalized eruption appears. Not infre- 
quently the temperature reaches 105 de- 
grees, twenty-four hours after the eruption 
is at its height. This high temperature is 
followed by a sudden drop of three or four 
degrees, or to almost normal, forty-eight 
hours after the eruption has fully appeared. 

To be on the safe side, every child with 
a cold in its head, with sneezing and cough- 
ing, should be put to bed at least until the 
fever subsides, unless the child has already 
had measles, 
complications Many cases of measles recover without 
any complication, but there are many others 
followed by sore eyes, a discharging ear, or 
by pneumonia. Now and then the pus germs 
which accompany measles will give rise not 
only to ear abscess, but also to an abscess 
in the chest-wall, called empyema. 

One of the worst complications following 

[198] 




MEASLES 

For description see text. 



Complication* 



HI 

103 01 About t 

a gen 

que mature 1 

g r » ours afte: 

is high t ature is 

a drop four 

>st norm, 
iiption has full 

de, every child ^ 
with sneezing and cough- 
st until the 

3.HJ2A3M 

jx 9 t 99 . noi^&aiMd has already 

measles recover without 
but there are many others 
es, a discharging ear, or 
and then the pus g 

les will givf 
. but also to an al 
lied empyema. 
Oi rst complications following 

[ i- 




'>■■■■■■■!■■ -■■■■'■■: .-.Vi' 



COMMUNICABLE DISEASES 

measles is tuberculosis. A neglected bron- 
chitis, followed by pneumonia, may extend 
over a long period of fever and finally ter- 
minate in tuberculosis. It is important, 
therefore, to know that complications may isolation 
follow an apparently innocent measles. My 
advice is to keep the child isolated and in 
bed from six to seven days in summer, and 
in winter from seven to ten days, after the 
eruption has appeared. The room should 
be kept at an even temperature of from 
70 to 72 degrees. Plenty of fresh air must 
be admitted. The light must be subdued, 
as the eyes usually are inflamed. The eyes 
should be washed several times a day with 
a boric acid solution. To stop itching the 
body should be rubbed with vaseline. Spe- 
cial rules for individual cases are required 
if the child has fever or other complica- 
tion. 

[199] 



HEALTH-CAKE OF THE GKOWING CHILD 

German Measles 

This is a mild form of rash resembling 
measles. After exposure the child will con- 
tract the disease in from seven to twenty- 
one days. Contrary to true measles, there 
is an absence of sneezing, running nose, 
and catarrhal symptoms such as bronchitis. 
The temperature is not as high as in mea- 
swoiien sles, rarely reaching 102 degrees. To dis- 

Glands 

tinguish German measles from true measles 
we have glandular swellings behind the ear, 
which are never present in true measles. 
The eruption is usually a pale red and va- 
TheRash ries in size from little spots the size of a 
pinhead to those of a pea. Sometimes the 
spots are isolated, again they will run to- 
gether. The eruption fades after four or 
five days and rarely has any complication 
associated with it. It is better, however, 
to keep the child in bed, protected, while 
the eruption lasts. 

[ 200 ] 



COMMUNICABLE DISEASES 

Scarlet Fever 

Scarlet fever is one of the most serious 
diseases on account of the complications 
which are liable to result. Vomiting is one 
of the first symptoms. There is fever, loss 
of appetite, and usually pain on swallowing. The Tongue 
There is a nasal tone of voice, caused by the 
tonsillar swelling. The tongue becomes 
coated white, with little red dots resembling 
a strawberry. A rash will be seen first on 
the neck and chest. It is of a pin-point The Rash 
character and has a bright scarlet color. 
In severe cases the rash will so run together 
that the skin resembles that of a boiled 
lobster. The rash usually spreads over the 
entire body and remains about from five to 
seven days, after which the skin begins to 
peel. On the palms of the hands, on the Desquamation 
soles of the feet, on the ears, and between 
the thighs peeling is very pronounced. 
It will take from two to three weeks, 

[201] 



HEALTH-CAKE OF THE GKOWING CHILD 

sometimes, four weeks, for the body to 
peel. 

On looking into the throat we will notice 
yellowish-white spots scattered over both 
tonsils, and sometimes also below and be- 
hind the soft palate. The glands below the 
jaw are always swollen. The temperature 
will range between 101 and 104 degrees 
early in the disease. Such children are 
irritable, and do not wish to be disturbed. 
They are thirsty and drowsy. 

We formerly believed that the disease 
was spread by the germs or poison con- 
tained in the peeled skin. We now know 
this to be wrong, as the germs die when 
exposed to sunlight. For this reason the 
board of health in New York City has 
stopped fumigation and disinfection of 
houses wherein scarlet fever occurred, 
isolation All cases of scarlet fever should be iso- 

lated. Healthy children should be removed 

[202] 



COMMUNICABLE DISEASES 

and not permitted to come in contact with 
the sick child, as the disease is spread by 
contact. 

If scarlet fever develops the child should 
be put to bed and kept there at least five 
weeks. This is not done to prevent the 
spreading of the disease, but because it 
takes several weeks for the poison to pass 
through the body by way of the kidneys, 
and also to restore the vitality of the heart. 

For restlessness a warm sponge-bath may 
be given under cover. A little alcohol may 
be added to the water. The food must be 
liquid during the first two weeks, such as 
milk and broths. Later custards, puddings, 
vegetables, and eggs may be added to the 
diet. Water should be given liberally. The 
bowels must move daily and the kidneys 
kept active. The kidneys may remain weak 
for several months or even several years 
after an attack of scarlet fever. 

[203] 



HEALTH-CAKE OF THE GKOWING CHILD 

Every mother should realize the impor- 
tance of having the nrine examined at least 
once a week, to guard against the develop- 
ment of a chronic nephritis or inflammation 
of the kidneys. The ears and the throat, 
likewise, demand supervision. 

The diet requires supervision. Many 
children will be compelled to abstain from 
meat and other protein foods, such as eggs, 
until the kidneys become normal, which may 
be months after the attack of scarlet fever 
began. 

After convalescence has been thoroughly 
established, the child's throat should be 
carefully inspected for the presence of ade- 
noids or enlarged tonsils. If diseased ton- 
sils or adenoids are present, they should 
be removed, as they are likely to be the 
source of another disease like diphtheria 
which may prove fatal. 

[204] 



COMMUNICABLE DISEASES 

Typhoid Fever 

This disease enters the body by means of 
the typhoid bacillus. The bacillus is found 
in water, in milk, and frequently in vege- 
tables. Contaminated creeks and pools of 
stagnant water may harbor the typhoid 
bacillus. If a case of typhoid exists in a 
household and the discharges from the bow- 
els or the urine are not properly disinfected, 
disease germs will remain alive and may be 
transmitted to others. 

The typhoid bacillus multiplies very rap- 
idly, and if it finds its way into a substance 
like milk, it can communicate the disease 
to any one drinking such milk. Small epi- 
demics have been reported in communities 
without the source of the infection being 
definitely known. These obscure epidemics carrier 
are usually caused by typhoid convalescents 
who carry typhoid germs in their throat 
and in the discharges from their bodies. 

[205] 



HEALTH-CAKE OF THE GKOWING CHILD 

These carriers can communicate to every 
one with whom they come in contact. It 
is well, therefore, to inquire before accept- 
ing a new cook or nursemaid as to her pre- 
vious history of illness and see if she is 
a carrier. 

The most common symptoms of typhoid 
are headache, fever, and loose, greenish 
stools. Typhoid fever may run a mild 
course, or it may run a severe course. It 
may last two to three weeks or extend over 
The three to six weeks. As a rule, there are 

Eruption 

small rose-colored spots visible on the ab- 
domen and chest. These spots are few and 
far apart. They are very small and re- 
semble neither scarlet fever nor hives. 

When a child is very languid and shows 
a slight rise of temperature ranging be- 
tween 100 and 102 degrees, with the above- 
named symptoms, it should be put to bed 
and watched. If the fever does not subside, 

[206] 



COMMUNICABLE DISEASES 

but rises from day to day, a blood-test 
should be made. As a rule, the positive 
diagnosis of typhoid fever can not be made 
until the second week of the disease, when 
we can get a positive Widal reaction in the 
blood. The urine will show a Diazo reac- 
tion which, combined with the other symp- 
toms, strengthens the diagnosis of typhoid. 
The spleen is usually swollen. If typhoid 
fever exists in the vicinity, one would nat- 
urally suspect this disease. 

Typhoid may be latent and require a week 
or ten days to develop properly. One is 
therefore safest in keeping every child 
having fever in bed until the nature of the 
disease is established. 

Typhoid is a milder disease in children 
than in adults; hence, with good care and 
strict attention to the diet, not permitting 
the child to have food which is contraindi- 
cated, the chances are far better than in 

[207] 



HEALTH-CAKE OF THE GKOWING CHILD 

adults. Children do not use alcohol, to- 
bacco, or coffee; hence, the heart-action is 
better and the system can undergo the 
strain of an infection like typhoid and re- 
adjust itself without complications more 
easily than that of the adult. 

As a safeguard against typhoid in an in- 
fected district, all milk, water, and food of 
all kinds should be boiled. Eaw vegetables 
and raw fruits eaten indiscriminately may 
have been the origin of the disease ; there- 
fore, all vegetables and fruits should be 
cooked. 
Diet The diet should consist of lamb or chick- 

en broth, split pea soup, boiled milk, butter- 
milk, albuminized tea, and water. Later, 
during convalescence, junket, custard, corn- 
starch, tapioca, and fruit juices may be 
given. 



[208] 



Chapter III 

SYSTEMIC DISEASES 
Appendicitis 

Appendicitis is not uncommon in children. 
The attacks are different from those we 
have in adults. It is important to recog- 
nize the symptoms. Fever is associated with 
all attacks. Some attacks begin with vom- 
iting and diarrhea and distended abdomen. 
Other attacks begin with pain, or cramps, 
and vomiting. Some children will have re- 
curring disturbances every month or two, 
with pain, fever, and diarrhea or consti- 
pation. We therefore have no distinct lo- 
calized pains on the right side in the region 
of the appendix, as is found in the adult. 

On examination of the abdomen we will 
usually detect a swollen or sensitive appen- 

[209] 



HEALTH-CAKE OF THE GKOWING CHILD 

dix. In nervous or unruly children, if we 
are suspicious of appendicitis, it will be 
necessary to give a few whiffs of laughing- 
gas (nitrous oxide) or a few drops of chlo- 
roform or ethyl chlorid to quiet the child 
so that the abdomen can be carefully exam- 
ined. In some cases it may be necessary to 
take an X-ray picture of the abdomen, to 
study the condition of the appendix. 

Attacks of colitis simulate appendicitis. 
If a child is constipated, retention of the 
stool and gas will give rise to distention 
and flatulence. An enema of soap and water 
will relieve this condition. If, however, 
we are dealing with appendicitis, then no 
relief will follow the emptying of the bowel 
by the injection. 
Pain in Do not be frightened whenever the child 

Abdomen 

complains of a pain in the abdomen. In a 
girl around the age of- development, or 
between the eleventh and fifteenth years, 

[210] 



SYSTEMIC DISEASES 

remember that cramps in the abdomen will 
appear for several months before actual 
menstruation takes place. 

Another reason for pains in the abdomen 
is the passing of small uric acid crystals 
through the kidneys, which will give rise 
to colicky pains. These pains may also 
appear on the right side in close proximity 
to the appendix. Colitis is one of the most colitis 
frequent causes of pain on the right side. 
This pain may be caused by dietetic errors. 
The eating of too much ice-cream or rich 
cream-cakes, or chilling the body by pro- 
longed bathing in the ocean, or by wading 
in lake water, may give rise to abdominal 
pains. 

Neuralgia of the intestine may be caused 
by the distention due to hard-formed and 
impacted stools. Such stools are hard and 
dry like marbles. From the pressure pain 
results. 

[211] 



HEALTH-CAKE OF THE GKOWING CHILD 

Tapeworms and round worms have been 
described in their respective chapters. They 
are frequently causes of abdominal pains. 
From what has been said, one can see that 
we should exercise caution in deciding that 
the child has appendicitis simply because 
pain exists in the abdomen. 

Malaria 

It is surprising to see how many children 
are supposed to suffer with malaria, and 
how few really have this disease. Malaria 
is an infection that gets into the blood and 
can be detected by the laboratory method 
of examining the blood. When blood con- 
tains Plasmodium, then malaria is present, 
not otherwise. The common symptoms of 
malaria in children are not the same as 
those found in adults. The spleen is always 
swollen in malaria. In children it is very 
difficult to note a chill, although chills are 

[212] 



SYSTEMIC DISEASES 

frequently present. The fever is high, The Fever 
reaching 104 or 105 degrees in the after- 
noon of every second or third day. Chil- 
dren complain of being tired, there is loss 
of appetite and irritability. Perspiration 
is usually noted. 

We rarely see cases of malaria in large 
cities, but when they do occur they are 
very easily recognized by the examination 
of the blood. Malaria in children is not a 
fatal malady. It runs the same course as 
in adults. There is loss in weight until the 
fever subsides. Change of air and a diet 
of concentrated foods — all dairy products, 
fermented milk, etc. — must be supplemented 
by giving quinin, and later on Fowler's 
solution, during recuperation. 

Very frequently tuberculosis gives symp- 
toms which are identical with malaria. No 
mother or nurse should rely on fever, per- 
spiration, and loss of weight in forming 

[213] 



HEALTH-CAKE OF THE GKOWING CHILD 

a conclusion that the child has malaria, 
unless the physician actually determines 
this condition by a blood-test. 

Growing-Pains 

Frequently physicians are asked what can 
be done for growing-pains. There is no 
such thing as a growing-pain. The body 
grows because of the physiological increase 
normal in childhood. There is no pain 
caused by the growth of the hair, the nails, 
the teeth, or the joints. 

When pains in the joints or muscles are 
described, the throat should be examined. 
As a rule, tonsillitis is a forerunner of 
joint or muscle pains, which are usually due 
to an inflammation of the membranes of the 
joint itself. 

Not infrequently physicians will note the 
existence of heart disease, which, on ques- 
tioning the family, can be traced back to 

[214] 



SYSTEMIC DISEASES 

a supposedly innocent attack of growing- 
pains. 

Therefore, if a child complains of pains 
in the joints, take him to a physician rather 
than run the risk of having chronic heart 
disease due to neglected rheumatic inflam- 
mation. 

Pains in the thighs or in the leg may be 
symptoms of tubercular hip- joint or knee- 
joint disease, and these points should be 
remembered before deciding that a pain 
in the leg, sometimes due to neglected ton- 
sillitis, can be due to growing. 

Rheumatism 

There are two kinds of rheumatism : mus- 
cular rheumatism and joint rheumatism. 
Muscular rheumatism usually follows ex- Muscular 

Rheumatism 

posure to a draught, as when riding in an 
open car on a damp day. These pains may 
be confined to any of the muscles of the 

[215] 



HEALTH-CAKE OF THE GKOWING CHILD 

body, the neck, the back, the arms, or the 
legs. 

The pains are noticeable only when the 
affected muscles are used. Turning the 
head or neck causes severe pain. Bending 
forward or sideways in rheumatism of the 
back, or when the arms and legs are ex- 
tended as in walking or reaching out causes 
pain which ceases when the extremities are 
not used. 

These rheumatic pains yield very easily 
when massage is used. A warm poultice 
is very soothing, and will frequently relieve 
the stiffness and pain. Such children 
should be kept in bed, as the warmth and 
rest do much good. In guarding against 
recurring attacks, warm underclothes should 
be worn, and the body given a warm bath 
before retiring, 
joint or Joint rheumatism is frequently called 

Inflammatory 

Rheumatism inflammatory rheumatism. One or more 

[216] 



SYSTEMIC DISEASES 

joints will be painful, swollen, and tender 
to the touch. There is usually fever, rang- 
ing between 100 and 102 degrees. In many 
cases throat trouble, such as tonsillitis, in- 
fluenza, or grippe, will be a forerunner of 
the rheumatic inflammation. It is there- 
fore important to place every child having 
a sore throat in bed for a few days rather 
than try to fight nature by constant expo- 
sure to the elements. Neglected colds, such 
as prolonged tonsillitis, are frequently com- 
plicated or followed by rheumatism. 

A condition known as rheumatic tonsil- 
litis is very common among children. When 
rheumatism begins in childhood it should 
be regarded with apprehension. The great 
danger consists in the frequency of relapses. 
Eecurring attacks of rheumatism mean a 
spreading of the disease from joint to joint. 
Not only may deformity of the joint and 
stiffening follow, but more often a heart 

[217] 



HEALTH-CAKE OF THE GKOWING CHILD 

complication may associate itself which can 
prove fatal. 
Treatment If removed from the city and a physician 

is not accessible, the first thing to do is to 
place the child in bed. Stop all meat and 
eggs. Give milk, buttermilk, and frnit 
juices, such as lemonade or pineapple juice, 
for thirst. 

The bowels should be kept loose by giving 
one-half teaspoonful of Eochelle salts in 
sweetened water every morning, and re- 
peating the dose every three hours until 
effectual. 

The joints should be protected with cot- 
ton and oiled silk. If very painful, an ice- 
bag may be applied. Many joints feel bet- 
ter with warm applications, such as dry 
bran. Often a tight, dry bandage is all 
that is necessary. 



[218] 



PART IV 

DISEASES OF THE SKIN AND 
NERVOUS SYSTEM 



[219] 



Chapter I 

DISEASES OF THE SKIN 

Rashes 

Thebe are dozens of rashes that may 
appear on a child's skin. Some of them 
are due to toxins from food taken into the 
body. Some children will always have a 
rash after eating oatmeal, shell-fish, straw- 
berries, or eggs, which shows a sensitive 
condition of the blood. (Read article on 
hives.) 

Whenever a rash is noticed, the tempera- 
ture should be taken. If fever exists, a 
physician should be called. 

There are many obscure rashes in which 
there may be little or no fever. The mother 
should examine the throat to see if small 
yellowish spots are present; if so, no time 

[221] 



HEALTH-CARE OF THE GROWING CHILD 

should be lost in calling a physician. Now 
and then scarlet fever develops without 
fever; this should be remembered. It is 
safer to call a physician to pass on a rash 
rather than neglect a rare type of eruption. 

Insect-Bites 

Mosquito bites or any insect sting causing 
swelling and blotches can be relieved by 
applying pure alcohol or spirits of cam- 
phor. If the part swells from scratching, 
apply lead water on gauze and cover with 
oiled silk. If fever develops, send for a 
physician. The great danger lies not in 
the poison of the insect bite as much as in 
the poison of the nails in scratching or 
getting germs into the swelling. 

A half teaspoonful of cream of tartar 
added to a glass of lemonade, if given sev- 
eral times a day, is cooling to the blood 
when intense itching is present. 

[222] 



DISEASES OF THE SKIN 

Eczema 

Eczema is an eruption of the skin which 
appears as reddish or yellowish scales, moist 
or dry, in round or irregular-shaped 
blotches. It will be found in many chil- 
dren on the cheeks, arms, legs, or any por- 
tion of the body. A favorite place for ec- 
zema is the scalp. There is an intense 
itching of the parts affected, especially at 
night. The itching is so intense that some 
children scratch until the parts bleed. They 
are peevish and irritable by day and rest- 
less and sleepless at night. 

As a rule, this condition is caused by 
errors in diet. Overfeeding of sugar, espe- 
cially too much candy and cake, and starchy 
foods, such as potatoes, may cause eczema. 
Large quantities of cereal, such as oatmeal 
and rice, are predisposing factors. Hered- 
ity plays an important part in eczema. As 
a rule, a father or mother suffering with 

[223] 



HEALTH-CAKE OF THE GKOWING CHILD 

eczema will usually have children so af- 
fected. Very fat children are prone to 
eczema. In many instances starvation and 
inanition due to the absence of fresh vege- 
tables, and the feeding of canned vegetables 
or canned condensed milk, may cause this 
condition. Deficient ventilation, lack of 
exercise, and unsanitary conditions, such 
as insufficient bathing, may cause eczema. 

Eczema may last for months and, if neg- 
lected, may become chronic and last for 
years. The first thing to do is to empty 
the bowels with a mild laxative. A child 
of from five to ten years may take one-half 
teaspoonful of compound licorice powder 
morning and evening for three days. This 
will cleanse the bowels, cool the blood, and 
relieve the itching and overheated skin. 

The diet should be regulated by giving 
milk; in no case is cream to be allowed. 
Buttermilk, fruit, and all fresh vegetables 

[224] 



DISEASES OF THE SKIN 

may be given. Meat and eggs must not 
be given. Cheese, fruit, bread, and a glass 
of milk may be given in the evening. Large 
quantities of water should be given to cool 
the body and to flush the kidneys. 

Water and soap should not be used on 
the skin. If the scales and crusts adhere, 
they may be loosened by soaking in an oat- 
meal bath. Oatmeal water is made by soak- 
ing for twenty minutes one pound of oat- 
meal in two quarts of boiling water. 

To relieve the itching an ointment, con- 
sisting of one teaspoonful of oil of tar added 
to and rubbed up with one ounce of zinc 
ointment, can be applied after the scales 
have been removed with the oatmeal bath. 
The salve may be used two or three times 
a day. Do not use soap and water to re- 
move the salve, but continue to use salve 
on top of salve. 

If the eczema is confined to the scalp, a 

[225] 



HEALTH-CARE OF THE GROWING CHILD 

lather of tar soap can be thoroughly rubbed 
in and the scalp shampooed until all the 
scales are removed. After the scalp is 
clean, rub in the tar and zinc oxid salve. 
Eepeat the shampooing every third night, 
but continue to use the salve morning and 
evening during the three days in which you 
do not shampoo the scalp. 

Erysipelas 

Erysipelas is an inflammatory affection 
of the skin resulting from the introduction 
of disease germs. These germs can be in- 
troduced by scratching or by lacerating the 
skin with a rusty nail or any unclean object. 
An open wound, or boil, or abscess, if it is 
not properly cleaned and bandaged, will fre- 
quently be infected by the introduction of 
erysipelas germs. We must exercise a great 
deal of care in handling a wound, as there 
is always danger of contamination. 

[226] 



DISEASES OF THE SKIN 

Any person dressing an open wound must 
wash his hands with soap and water before 
each dressing is changed. The finger-nails 
must be thoroughly scrubbed, and all ac- 
cumulated dirt underneath removed. 

Erysipelas manifests itself as a reddish 
glossy flush which usually extends several 
inches around a wound. The temperature 
varies between 101 and 104 degrees. The 
skin feels hot and appears thick and swollen. 

The infection spreads rapidly, and a flush 
which began at the nostril can extend to the 
cheeks, forehead, and scalp in a few days. 
Herein lies the danger. No case of ery- 
sipelas should be neglected, as the child's 
life may be endangered. 

Ringworm 

Eingworm is a contagious disease caused 
by the invasion of a fungus. Its favorite 
location is on the scalp. It is not a worm 

[227] 



HEALTH-CAKE OF THE GKOWING CHILD 

as the name implies. It is not always in 
ring-shape. It is recognized by patches 
sometimes circular, sometimes oval, in 
shape by scaly grayish-white marks, look- 
ing as if they were covered with dust and 
ashes. These marks are covered with 
stumps of hair, which shows that hairs 
have been broken off, this being the dis- 
tinguishing mark of the disease. Although 
curable, some forms of the disease take 
years to eradicate. 

It is usually transmitted by clothing such 
as caps, towels, and pillow-cases containing 
the spores. 
Treatment The first step in the treatment is to have 

the hair clipped short. After a thorough 
cleansing of the scalp with tincture of green 
soap, a thick coating of tincture of iodin 
should be applied. Three days later an- 
other washing of tincture of green soap 
should be given, and later a coating of tinc- 

[228] 



DISEASES OF THE SKIN 

ture of iodin. If after several applications 
of the above no improvement is seen, then 
an application of a 5 per cent, chrysarobin- 
ointment should be given morning and 
evening until improvement is noted. If the 
skin is sensitive and shows inflammation 
after several applications, then two days 
should elapse before the next application 
is made. 

In institutions, nurseries, and . schools, 
children should be isolated while suffering 
with ringworm. The danger in boys as well 
as in girls consists in the baldness which 
may be permanent after the ringworm dis- 
appears. 

Ivy-Poison 

Ivy-poisoning manifests itself by an in- 
tense inflammation of the skin, caused by 
contact with the poison-ivy plant. Some 
children are so susceptible to it that they 
need only come moderately near it to have 

[229] 



HEALTH-CARE OF THE GROWING CHILD 

the rash come out. The rash usually comes 
out within a few hours after exposure. The 
skin becomes hot and red. There is intense 
itching and swelling. Crusts form from 
the dried discharges of the vesicles that 
form on the inflamed surface. The swelling 
sometimes becomes so intense that the eyes 
can not be opened. 

The intense itching and swelling can best 
be relieved by a tub-bath containing sulfur, 
the crude sulfuret of potassium, one-half 
pound to a large tub of water, temperature 
sulfur Bath 100 degrees for a full body bath. These 
baths may be given morning and evening. 
Until the sulfur can be obtained bicarbonate 
of soda and water will relieve the itching. 

Sunburn 

After exposure to the sun, the burn may 
be relieved by applying a mixture contain- 
ing zinc-oxid three teaspoonfuls, lime-water 

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DISEASES OF THE SKIN 

three ounces, and rose-water three ounces. 
Bathe the skin or saturate a piece of gauze 
and apply every hour. Linen underwear 
will cool the skin, so will silk. Kice-flour 
or corn-starch used as a dusting-powder is 
soothing. 

Frost-Bite 

Long exposure to cold frequently results 
in frost-bite. The parts usually affected 
are the fingers, toes, ears, or nose. If ex- 
posed to cold too long the skin becomes 
numb, white, and wrinkled. Upon coming 
into a warm room the parts become red, 
swollen, and itching. Sometimes blisters 
form over the skin. 

If a child has been overexposed to the 
cold, it should be brought to a warm room 
gradually. The hands or parts affected 
should not be held near the heat, but should 
be dipped in cold water and constantly 
rubbed. This water can be gradually 

[231] 



HEALTH-CAKE OF THE GKOWING CHILD 

warmed until it reaches room-temperature. 
The parts can later be bathed in camomile- 
tea at a temperature of 90 degrees until 
the skin is thoroughly macerated or shriv- 
eled. Owing to the serious nature of 
frost-bite the child should receive medical 
attention if the above treatment is of no 
avail. 

Hives 
An eruption of large red blotches with 
whitish centers, resembling mosquito-bites, 
is known as hives. They are found in 
children whose blood is sensitive to certain 
proteins. For example, some children will 
have hives after eating oatmeal, others after 
eggs, strawberries, lobster, or crab. Such 
children usually have severe rashes follow- 
ing an injection of antitoxin. If ill with 
diphtheria it is important for the mother 
to call the physician's attention to the sus- 
ceptibility of her child. 

[232] 



DISEASES OF THE SKIN 

Milk of magnesia or citrate of magnesia 
should be given as a laxative. Bhubarb 
and soda may be given to cool the blood. 
Locally, bicarbonate of soda and water will 
allay the itching. 

Itch 

Itch usually appears between the fingers 
and the toes in the form of a moist, scaly 
eruption. It is caused by a fungus or germ 
which gives rise to an intense irritation. 
Scratching causes bleeding. The eruption 
is frequently found on the face. It is usually 
contracted from some other child. The 
school and classroom where children play 
together is the most usual source of spread. 
Relief can be afforded by bathing the af- 
fected parts with warm sulfur-water, ten 
to fifteen minutes, then applying sulfur 
ointment and a snug-fitting bandage to pre- 
vent scratching. This condition will last 

[233] 



HEALTH-CARE OF THE GROWING CHILD 

many weeks, and persistence in the treat- 
ment will be necessary to effect a cure. 

Warts 

These small growths may appear singly 
or in bunches like cauliflower. They usually 
appear on the moist surfaces of the body, 
the rectum, the vagina, or in the armpit. 
They appear on the hands, the feet, and 
the neck. 

A bit of absorbent cotton on the end of 
a toothpick should be dipped into carbolic 
acid and applied to the surface of the wart. 
After three minutes apply in like manner, 
on fresh cotton and toothpick, fuming nitric 
acid. This second application will turn the 
wart black. In order not to burn the sur- 
rounding skin, cold cream or vaseline should 
be applied around the root of the wart be- 
fore applying the acids. This treatment 
may be repeated every three days. 

[234] 



DISEASES OF THE SKIN 

Another successful method is to apply a 
stick of nitrate of silver, or to have a physi- 
cian cauterize the warts by first applying 
ethyl chlorid and then using a galvano 
cautery. 

Head-Lice 

In school, kindergarten, or where chil- 
dren assemble head-lice may be contracted. 
Especially does this vermin exist in con- 
valescent children deprived of proper care. 
In the chapter on swollen glands, I have 
mentioned that swollen glands at the root 
of the hair, at the back of the neck, fre- 
quently owe their origin to head-lice. The 
first symptom to appear is itching. 

At hospitals and institutions we order 
the hair cut short and the scalp saturated 
with kerosene. The child wears a bathing- 
cap during the night, and in the morning 
the scalp is shampooed with soap and water. 
Repeat if necessary every third night until 

[235] 



HEALTH-CAKE OF THE GROWING CHILD 

the scalp is clean. This treatment destroys 
the living parasite. Instead of the kerosene, 
two ounces of larkspur with one ounce of 
vinegar and one ounce of ether can be ap- 
plied to the scalp after a thorough shampoo. 
This can be repeated nightly until all lice 
are destroyed. 

The female lays eggs in vast numbers, 
these eggs stick to the hair-shaft and are 
recognized as tiny grayish-white bodies. 

These " nits' 9 or eggs can not be removed 
by brushing, no matter how persistently one 
brushes, and this proves their identity, for 
dandruff and crusts would easily be re- 
moved by a hard brush. 
Nits These nits can best be removed by satu- 

rating the hair with strong vinegar or with 
pure alcohol and using a fine-toothed comb, 
being careful not to touch the scalp if it has 
any sores or scratches. Olive-oil may be 
applied to any sores on the scalp. 

[236] 






DISEASES OF THE SKIN 

Dandruff 

Deficient lubrication by the oil-ducts 
causes dryness of the scalp, and the skin 
peels off in fine white particles. These par- 
ticles destroy the hair-roots and should be 
removed by washing. Poor circulation may 
be aided by massage of the scalp. The 
scalp should be washed with tar-soap, the 
lather being rubbed into the scalp or hair- 
roots, rinsed thoroughly with lukewarm 
water, followed by cold water, and rubbed 
dry. After the hair is dry, massage with 
alcohol containing 1 to 1000 bichlorid of 
mercury, then apply sufficient borated vase- 
line to oil the scalp but not the hair itself. 
Eepeat the washing and massage every 
other night for two weeks; later once a 
week will be sufficient. 



[237] 



Chapter II 

DISEASES OF THE NERVOUS SYSTEM 

Defects of Speech 

stammering Among the most important of the com- 

mon nervous defects of childhood are 
stammering, stuttering, and lalling. Stam- 
mering is due to incoordination of the 
muscles involved in articulation. Stutter- 
ing results from repeated contractions of 
the muscles concerned in forming some ini- 
tial syllable. Lalling is baby-speech, in 
which wrong consonants or vowels are em- 
ployed and the pronunciation of the words 
is slurred. Each of these defects is curable, 
and we must therefore ascertain the prin- 
ciples underlying their treatment. 

The mechanism of speech is twofold — 
vocalization and articulation. The former 

[238] 



DISEASES OF THE NEEVOUS SYSTEM 

which is produced by the vibrations set up 
in a column of air passing over the vocal 
cords depends on the movements of breath- 
ing, on the vibrations of the vocal cords, 
and on the resonating cavities in the head 
and in the neck. By its help the five "physi- 
ological" vowel sounds are produced, name- 
ly, EE, A, AH, 0, and 00. Articulation 
is produced by totally different means. The 
current of air from the lungs is interrupted 
or released by the muscular action of the 
lips or of the tongue at one of three situ- 
ations — the so-called "stop-positions." In 
the first stop-position the lips are suddenly 
parted or brought together so that one of 
the following consonants is uttered — P, B, 
W, M. The second stop-position is formed 
by pressing the tongue against the hard 
palate; the consonants that now result are 
T, D, L, N, R (and SH). The third stop- 
position is nearer the back of the mouth, 

[239] 



HEALTH-CAKE OF THE GKOWING CHILD 

and is used to form the consonants K, G 
(girl), and Y. 

In the majority of cases the nature of the 
defect is essentially a want of harmony be- 
tween the mechanisms of vocalization and of 
articulation; the child is unable to pass 
either smoothly or quickly from one to the 
other. In almost all cases the difficulty lies 
not in articulating, but in vocalizing, and 
therefore our first step in treatment must 
be to teach the child how vocalization differs 
from articulation. We must then make him 
give special attention to his vowel sounds, 
and, in order to increase his command over 
them, we should begin by teaching him to 
take steady breaths and to control his ex- 
pirations. When he has acquired this power, 
he must be exercised in the different vocal 
sounds. 

The consonants are to be learned in three 
groups, namely, the " voiceless" consonants, 

[240] 



DISEASES OF THE KEKVOUS SYSTEM 

P, F, Th (thin), S, Sh, T, and K, which are 
without any vocal element; the " voiced' ' 
consonants, B, W ', V, Th (thou), Z, Bh, D, 
L, R, G, and Y; and the voiced nasal con- 
sonants, M, N, and Ng. The important 
point in learning this classification is that 
the vocal element in the last two groups 
should be given their full value. Thus, in 
pronouncing the three words, brown, prim, 
and mind, the child must give the full vocal 
character to the initial consonants of the 
first and last words, bur-own and um-ind; 
but the second word, beginning with a voice- 
less consonant, can be pronounced only as 
pr-im. 

When these consonants have been learned 
by the aid of single words, the child should 
begin to practise sentences. 

In doing this his attention must be spe- 
cially directed to vocalization. There is no 
better way of enforcing this precaution than 

[241] 



HEALTH-CAKE OF THE GKOWING CHILD 

by making him intone in clerical fashion. 
He will then be compelled to attend rather 
to his voice than to his articulation. His 
earliest sentences should be made up of 
words whose initial consonants are all either 
voiceless or voiced. In order to acquire 
facility in the use of the various stop-posi- 
tions, he should be given sentences to prac- 
tise which contain the consonants produced 
at the several positions; thus, for the sec- 
ond position, a sentence such as "Not till 
late did she return." 

These are the simple lines on which stam- 
mering is to be treated. Frequent practise 
is essential, and the exercises are to be se- 
lected according to the particular difficul- 
ties of speech in each case. By testing the 
child's vocalization and articulation as soon 
as he comes under treatment, we shall have 
no trouble in ascertaining wherein lies his 
defective power. 

[242] 



DISEASES OF THE KEKVOUS SYSTEM 

In cases of lalling, the letters that can not Laiiing 
be pronounced must be found out by making 
the child repeat the vowels and the con- 
sonants. Each of the latter must be tested 
as an initial letter, as a terminal letter snd 
as a middle letter (Forsyth). 

Chorea 

Chorea is frequently called St. Vitus 's 
dance. It consists of involuntary twitchings 
of the muscles of the face. It may also 
affect the muscles of the arms or legs so that 
walking is jerky, and any movement of the 
arm is spasmodic in character. These 
twitchings occur when the child is awake, 
but never while asleep. 

Eye-strain, due to overwork at school, 
shock, fright, and fear, are among the causes 
of this condition. 

Frail, nervous children are more suscep- 
tible than strong, hardened children. In 

[243] 



HEALTH-CAKE OF THE GROWING CHILD 

rare instances astigmatism has been men- 
tioned as a cause, although I have never 
known it to be the cause. Many children 
acquire this habit by imitation. They will 
imitate other children who twitch until 
Hawt-spasm it becomes a habit. This is called habit- 
spasm. 

If school or overwork is the cause, the 
child should be sent to the country. Cold 
showers or baths to tone the nervous sys- 
tem are very important. Meat, coffee, and 
too many eggs are stimulating, and should 
be prohibited. Vegetables, fruits, cereals, 
cheese, milk, and buttermilk should form 
the bulk of the diet. The eyes must rest; 
reading should be prohibited. Resting the 
eyes with a smoked glass or placing the 
child in a darkened room several hours a 
day will soothe the nervous system. 



[244] 



DISEASES OF THE NEKVOUS SYSTEM 

Convulsions or Spasms 

Convulsions are frequently met with in 
childhood. An overloaded stomach result- 
ing in high fever will cause congestion of 
the brain, and may result in convulsions. 
Where an adult might have a headache, a 
child may get a convulsion. 

Sensitive, nervous, and frail children, 
especially those who have frail bones, mus- 
cles, and nerves, are susceptible to convul- 
sions. 

Convulsions occur suddenly. An appar- 
ently healthy child will, without warning, 
become rigid. The eyes will become fixed 
and will stare, the jaws will stiffen, and 
there may be frothing at the mouth. Breath- 
ing will sometimes be suspended for a mo- 
ment. Along with rigidity of the body the 
muscles will twitch, especially the muscles 
around the eyes and mouth. At times the 

[245] 



HEALTH-CARE OF THE GROWING CHILD 

color 'of the skin will be bluish, although the 
skin will feel hot to the touch. 
Treatment No time should be lost when a convulsion 

occurs. The feet should be immersed at 
once in very warm water, containing a ta- 
blespoonful of mustard. If possible, a whole 
bath containing several handf uls of mustard 
should be given. This bath should be pro- 
longed about two minutes. The body should 
then be wrapped in a warm blanket, placed 
on the bed, and cold cloths or an ice-bag 
applied to the forehead and scalp. 

As a rule, convulsions last from one to 
five minutes, rarely longer. When the con- 
vulsion ceases, and the child is relaxed, lose 
no time in giving an enema of one pint of 
soap-water, to relieve the bowels. 

Remember, that during a convulsion the 
jaws are rigid ; therefore, the child can not 
swallow. One should not attempt to give 
any medicine by the mouth, for there is 

[246] 



DISEASES OF THE NERVOUS SYSTEM 

danger of the same trickling into the lungs 
instead of the stomach. 

These instructions are to be followed un- Recurring 

Convulsions 

til a physician arrives. If a second convul- 
sion occurs before the physician arrives, re- 
peat the mustard bath, and again apply ice 
to the forehead and scalp. 

In prolonged convulsions it may be neces- 
sary for the physician to use a few drops 
of chloroform or ether by inhalation to con- 
trol the spasm. This, however, must not 
be attempted by the family without the 
presence of a physician or a trained nurse, 
as there is danger of asphyxia when proper 
precautions are not taken. 

Convulsions in children usually indicate 
the beginning of a disease. Diseases like 
pneumonia, typhoid fever, whooping-cough, 
and meningitis may be ushered in with a 
convulsion. This convulsion is the effect of 
the poison (toxin) on the nerve centers. In 

[247] 



HEALTH-CAKE OF THE GKOWING CHILD 

pneumonia the pneumotoxin develops in the 
blood, and this causes the convulsion. 

When a child has a convulsion it should 
be put to bed and kept there for observa- 
tion. Sometimes a few days will pass be- 
fore a disease appears. If the convulsion 
is simply an explosion due to an overloaded 
stomach, the child, after a brisk cathartic 
and rest, will be normal in a few days. We 
should always remember that if a child has 
once had a convulsion he may have a recur- 
rence of the same, 
concussion If a child falls and strikes his head, a 

convulsion may occur. This may be due 
to a concussion or jar of the brain, but it 
may also be due to meningitis or brain- 
fever. Such cases are not necessarily fatal. 
Children fall and strike their head many, 
many times without doing any serious dam- 
age. A good plan, however, is to have the 
head carefully examined after any severe 

[248] 



DISEASES OF THE NEKVOUS SYSTEM 

fall. If nosebleed, or earbleed, or bloodshot 
eyes are noticed soon after an injury, or if 
vomiting takes place, it shows that there 
has been some disturbance, usually due to 
the force of the concussion of the brain. 

These cases may be serious, but are not 
necessarily fatal. Children have enormous 
vitality and can survive many injuries to 
the brain and skull which would prove fatal 
to adults. Nature repairs injuries to bones 
very quickly. 

Tuberculous Meningitis 

Tuberculous meningitis usually occurs in 
bottle-babies, in which milk contaminated 
with the tubercle bacillus was fed during 
infancy. Such children do not thrive; the 
skull is large, the veins are very prominent 
over the forehead and scalp, the nights are 
restless with crying, and in spite of good 
care the child does not seem to develop. 

[249] 



HEALTH-CAKE OF THE GKOWING CHILD 

Such children will cry out in a sound sleep, 
as though frightened, and stare at imagi- 
nary objects. They are unhappy, dissatis- 
fied, and always fretful. They perspire at 
night. They cough without any evidence of 
lung trouble. Frequently convulsions and 
rigidity of the muscles are noted. When 
convulsions convulsions recur it is due to an excess of 
fluid in the brain, causing pressure within 
the skull. To relieve the same the physician 
must draw off some of the fluid by insert- 
ing a needle into the spinal canal. By this 
method one-half to one ounce of the spinal 
fluid can be drawn off. By a laboratory 
examination we can determine whether or 
no the child is suffering with tuberculous 
meningitis, or cerebro-spinal meningitis and 
at the same time relieve the brain pressure. 
There are many conditions in children 
causing disturbed nights, restlessness, and 
crying. A pain in the stomach or bowel 

[250] 



DISEASES OF THE NEKVOUS SYSTEM 

due to overeating may cause colic and symp- 
toms resembling meningitis. Children with 
flabby muscles and soft bones suffering with 
mild or severe rickets are easily disturbed 
and peevish, and scream during sleep. 
Thus we have irritation causing symptoms 
which resemble meningitis. We should not 
make the mistake, therefore, of believing 
that every child that stares at imaginary 
objects, or appears frightened, or has en- 
larged veins over the scalp is suffering with 
brain irritation or meningitis. A physician 
must decide this important point. 

Night-Terrors 

Sometimes children will suddenly awake 
from a sound sleep and shriek or scream. 
Very heavy meals at night, with overloaded 
bowels, will sometimes cause a disturbed 
sleep. Besides irregularity of meals, worms, 
and pain caused by kidney stones, an irri- 

[251] 



HEALTH-CAKE OF THE GROWING CHILD 

tation due to an adherent or elongated pre- 
puce, will disturb sleep. 

Ghost stories and too rigid discipline will 
excite mental impressions which will pro- 
duce night-terrors. The cause of the fright- 
ened scream must be sought by the one 
in charge, and the same can then be reme- 
died. 

Very sensitive, nervous children are more 
prone to these attacks than the strong, 
healthy, and robust child. 

When night-terrors exist, meat should be 
stopped, likewise tea and coffee. If chil- 
dren have been given beer, wine, or alco- 
holic spirits, the cause of such fright-spells 
is easily determined. 

A laxative consisting of one-half tea- 
spoonful of calcined magnesia should be 
given every morning and the bowels washed 
with a pint of soap-water in the evening. 

Milk, fruit, vegetables, eggs, cereals, and 

[252] 



DISEASES OF THE NEKVOUS SYSTEM 

fish should be allowed. Meat may be given 
sparingly. 

Paralysis 

Paralysis of the arms or legs, or inability 
to swallow, with regurgitation of food 
through the nostril, is the form of paral- 
ysis usually following diphtheria. Such 
paralysis usually lasts several months, and 
the child may recover completely. Now 
and then a case may persist for a year, but 
the paralysis, under appropriate treatment, 
gradually lessens until the child recovers. 
I have seen cases of permanent paralysis 
of both legs following severe diphtheria, 
but fortunately this is rarely the case. 

Paralysis accompanying scarlet fever or 
diphtheria comes on slowly and disappears 
slowly. The cause of the same is the poison 
or toxin from the disease germs which 
paralyze the nerve centers. 

After a fever in which symptoms of a 

[253] 



HEALTH-CARE OF THE GROWING CHILD 
infantile spoiled stomach are noted, paralysis may 

Paralysis or 

poliomyelitis suddenly appear. Many children will go 
to school in the morning, have fever in the 
afternoon and evening, and awake the fol- 
lowing morning unable to walk. The fever 
subsides quickly. The paralysis remains. 
There is a gradual waste of flesh which is 
very perceptible after a few weeks. The 
arm or leg affected is cold to the touch, 
and in contrast to the healthy extremity 
shows marked changes. This form of paral- 
ysis lasts throughout life. 

Braces and supports have given the best 
results. Plaster of Paris has been tried 
with rest in bed and immobilization of the 
parts, but the results are disappointing. 
Massage, electricity, and a metallic brace 
are about the only successful methods in 
use to-day. If there is shortening of the 
muscles, then muscle-grafting may be tried. 

This form of paralysis requires very skil- 

[254] 



DISEASES OF THE NEKVOUS SYSTEM 

ful treatment, and gymnastics must form 
the most important part of muscle educa- 
tion. 

I always advise placing such a child un- 
der the care of one skilled in medical gym- 
nastics and muscle education, so that the 
muscle strength can be gradually restored. 

Spinal Curvature 

Curvature of the spine is met with in 
both sexes. As a rule, curvatures are caused 
by weak muscles of the spine. We must 
therefore expect curvature in those children 
in whom exercise is neglected. 

Faulty position assumed in sitting at 
school or at home, or standing on one foot, 
while not the direct cause of a curvature, 
will aggravate and keep up a curvature that 
might otherwise improve. 

Spinal curvatures are usually associated 
with bad chest development. Improper 

[255] 



HEALTH-CAKE OF THE GKOWING CHILD 

breathing and flat-chested children go to- 
gether. One follows the other. An im- 
proper development of the chest wall is 
visible in the front ; so will a curvature of 
the spine, as a rule, be associated with 
faultily developed chests. 

To cure a curvature medicines are use- 
less. The treatment consists in the devel- 
opment of the chest wall, and especially of 
the spinal muscles, which can only be ac- 
complished by gymnastics. Deep breathing 
exercises, pulley weights, dumb-bells, row- 
ing, and especially swimming, are samples 
of exercises best adapted to develop both 
sides of the chest and spine. 

It is best, however, if a curvature exists, 
to take the child to a specialist and have 
him prescribe the exercises to be followed 
in a gymnasium. The measurements of the 
child should be taken, so that the progress 
of development can be noted. Spinal curva- 

[256] 



DISEASES OF THE NEKVOUS SYSTEM 

tures can be cured unless we are dealing 
with bone disease such as tuberculosis of 
the spine. 

Headache 

When a child complains of headache, we 
should suspect constipation or stagnation 
of the intestinal contents. When poisons 
from the bowels are absorbed into the body, 
they give rise to violent headache. Such 
putrefactive conditions will cause an auto- 
intoxication. If, however, the bowels are 
regular and there has been no imprudence 
in eating, the temperature should be taken. 
If there is any fever, the child should be 
put to bed. Headache may mean constipa- 
tion, but it may also mean the beginning of 
an acute infection, like influenza, scarlet 
fever, measles, diphtheria, or typhoid. It 
also frequently precedes an ear abscess. 
Eye-strain is a frequent cause of headaches 
in schoolchildren. We should always ques- 

[257] 



HEALTH-CAKE OF THE GROWING CHILD 

tion the child as to what portion of the head 
aches, and note if it is over the eyes, and 
Eye-Giasses if it follows reading or studying. If the 
headache disappears when the child rests, 
such headache may be caused by eye-strain. 
Such children usually suffer with astigma- 
tism. Their eyes should be examined by an 
oculist, but not by an optician. The mus- 
cles of accommodation in the eye are very 
sensitive, hence only one skilled in testing 
eyesight should undertake such a delicate 
examination. 

Every optician sells eye-glasses, and it is 
to his advantage to enlarge his trade, but 
the* delicate eyes of a child can be ruined 
if improper lenses are fitted to them. 

Some children require glasses for read- 
ing only, others may require two sets of 
glasses — one for distance-sight, the other 
for reading and writing. 

When girls between twelve and fifteen 

[258] 




o 
Cm 

bo 
a 



m 

+-> 
o 

o 
O 



OS 

o 

PL, 

be 

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172 



DISEASES OE THE NEKVOUS SYSTEM 

years complain of headache, one should bear 
in mind that menstruation is frequently 
preceded by headaches and also by nose- 
bleed. Recurring headaches at intervals 
of several weeks should always remind the 
mother of the approaching menstrual flow, 
if the girl has already begun to menstru- 
ate. If there is a cessation of the flow and 
an interval of two or three months has 
passed since the last flow, headaches will 
frequently occur. Such headaches are 
caused by an overfilling of the blood-ves- 
sels of the brain, and can best be relieved 
by giving a hot mustard foot-bath. Nose- 
bleed frequently occurs when menstruation 
is delayed. 



[259] 



PART V 

MISCELLANEOUS DISEASES AND 
AFFECTIONS 



[261] 



OPERATIONS IN CHILDREN 

Before deciding upon any surgical opera- 
tion which necessitates the administration 
of an anesthetic, there are a few points 
which have an important bearing on the 
outcome of any case. 

We should be positive that the child is "Bleeder 1 
not a " bleeder.' ' This can be easily ascer- 
tained by the physician. A specimen of 
blood can be sent to a laboratory to find out 
in what length of time coagulation takes 
place. By this means the physician learns 
whether or no the child is a " bleeder. ' ' The 
mother or nurse can also help to elucidate 
this point by noting if bleeding of an un- 
usual amount results after the extraction of 
a tooth or after a pin-prick or slight cut. If 

[263] 



HEALTH-CAKE OF THE GKOWING CHILD 



when bleeding occurs it is stopped with dif- 
ficulty, the child has a tendency to bleed, 
and the same should be reported to the phy- 
sician or surgeon. 

The Kidneys An equally important point is to have 
the urine examined so that we can learn 
whether or no kidney-disease exists. If 
albumin is found in the urine, the same 
should be remembered, for it will have a 
bearing on the choice of an anesthetic. 

Bronchitis A tendency to bronchitis should be men- 

tioned. If there is a tendency to bronchitis, 
the use of ether as an anesthetic is contra- 
indicated, as the ether will irritate the 
bronchial tubes. 

A weak heart or heart-disease requires 
caution in using nitrous oxid or chloroform. 
It is safer to have a physician present dur- 
ing a nitrous oxid anesthesia, even though 
only a tooth is extracted — if heart-disease 
exists. 

[264] 



HERNIA 



HERNIA 



A hernia is a loop or fold of intestine 
which passes through the muscular struc- 
ture of the abdomen. It is easily seen and 
felt in the groin on either side as a round 
or irregular mass which protrudes and gets 
larger on coughing or pressing. 

Girls as well as boys are easily ruptured 
by active athletics. When children over- 
strain they are liable to rupture. Many 
children have a tendency to rupture because 
of soft, flabby muscles. Children who have 
suffered with rickets are easily ruptured. 
Children whose muscles have been strained 
by violent fits of coughing, as in whooping- 
cough, are easily ruptured. 

The rupture always comes down when the 
child is on the toilet, especially if it strains 
its bowels. Such rupture is called an in- 
guinal hernia. Boys frequently have a large 

[265] 



HEALTH-CARE OF THE GROWING CHILD 

swelling or rupture which enters the sac 
containing the testicles. It consists of a 
fold of intestine forced through the inguinal 
ring. 

The treatment in these cases consists in 
keeping the bowels so loose that the child 
need not strain. Constipation is frequently 
at the root of this trouble. A truss should 
be fitted to the parts so as to support and 
prevent the rupture from protruding. 

Bread, cake, pies, pastries, and foods giv- 
ing hard and formed stools must be avoided 
during treatment. 

A child having a rupture should be taken 
to a physician so that the mother can learn 
how to prevent the rupture from being 
strangulated. 

GLANDS 

Lymphatic Glands are small, oval bodies about the 

Glands 

size of an almond. In health they give off 

[266] 



GLANDS 

secretions; for example, the saliva comes 
from the salivary glands in the mouth. 
During fever the mouth is dry, and the lips 
are parched, hecause the glands do not per- 
form their function. 

Intestinal glands during fever do not 
give off secretions, or only a very small 
quantity; consequently we have constipa- 
tion or dryness of the stool. 

Glands are found in almost every part 
of the body. We have bronchial glands, 
stomach and intestinal glands, also throat-, 
nose-, and mouth-glands. When inflamed Enlarged 

Glands 

they swell to two or three times their nor- 
mal size. Swollen glands usually indicate 
a nearby inflammation. When the glands 
swell at the lower jaw or behind the ear 
we should examine the mouth to see if the 
child has an abscess at the root of a tooth 
or on the gum. There may be a swelling 
at the back of the throat, or the tonsil may 

[267] 



HEALTH-CAKE OF THE GROWING CHILD 

be inflamed or have an abscess developing. 
In many instances the swelling of the glands 
will continue, and the gland itself break 
down and result in an abscess. . 

If there is an eczema on the scalp due to 
head-lice, the glands in the back of the neck 
near the roots of the hair will be swollen. 
Inspectors of schoolchildren invariably ex- 
amine the back of a child's head near the 
neck in order io determine the hygiene of 
the scalp. Glands will also swell in many 
other diseases which will be described else- 
where. 
Tuberculous Tuberculosis frequently shows itself by 

Glands * J J 

an enlargement of the glands under the jaw 
and neck. These glands enlarge and remain 
swollen for months and years even though 
diseased tonsils and adenoids are removed. 
There is but one treatment for this condi- 
tion and that is to remove them. When an 
abscess forms in a tuberculous gland the 

[268] 





Tuberculous Glands of the Neck, behind which diseased tonsils 
and adenoids were found. 



GLANDS 

pus should be evacuated as soon as possible. 
I have already mentioned the absence of 
fever in tuberculous glands in the article 
on tuberculosis. The same treatment that 
is given for other tuberculous conditions 
(see chapter on tuberculosis) is indicated. 

The body must be fortified with the aid 
of concentrated food, such as milk, cheese, 
eggs, fruits, and vegetables. Cakes, pies, 
puddings, and candies should not be given, 
or only in moderation. To assimilate the 
food, fresh air and outdoor life are de- 
manded. This will sharpen the appetite 
and aid digestion. An outdoor life, with 
porch-sleeping, soothes the nervous system 
and promotes sleep. The constant supply 
of oxygen taken into the lungs when awake 
and during sleep strengthens the blood, 
gives resistance to the body, and eventually 
helps to cure the disease. 

To throw off the poison from the skin and 

[269] 



HEALTH-CAKE OF THE GROWING CHILD 

glands it is necessary to resort to daily 
baths. A tepid bath followed by a cold 
shower and brisk massage will stimulate 
the circulation and help to restore good 
health. Medicine alone will not cure tuber- 
culosis. 

FAINTING 

Attacks of syncope are frequently seen 
in children when riding in cars. The jar- 
ring of the train will disturb the brain and 
nervous system so that a faint or nausea 
and vomiting may result. A sudden shock 
or fright will sometimes cause a disturb- 
ance of the circulation resulting in a faint. 
Indigestion may cause a fainting-spell, 
while at the same time there will be a cold 
perspiration of the hands, feet, and fore- 
head. There is danger unless the circula- 
tion is quickly restored. 

The child should be undressed and put 

[270] 



FAINTING 

to bed. Massage or rub the region of the 
heart around the left nipple for a few mo- 
ments. The feet should be immersed in hot 
water. Care must be taken that the feet are 
not scalded. Five to ten drops of whisky 
or brandy or aromatic spirits of ammonia 
should be given and repeated every five min- 
utes until three doses have been taken. The 
face should be sponged with alcohol and 
water or with Florida water every few 
minutes. 

Even though the child craves drink avoid 
giving large quantities of liquids. Thirst 
should be quenched by giving small pieces 
of cracked ice with or without brandy. 

After the child is revived discontinue 
foot-baths and let him rest. Hot coffee 
with milk will assist in steadying the heart- 
action and prevent the recurrence of such 
fainting-spells. 

If the abdomen is distended give an 

[271] 



HEALTH-CAKE OF THE GROWING CHILD 

enema of one pint of soap-water. By reliev- 
ing the bowels we remove the pressure on 
the diaphragm which lies directly under the 
heart. 

No child should be permitted to walk for 
at least one day after an attack. Rest is 
demanded so that the heart shall not be 
overstrained. 

COLD HANDS AND FEET 

Cold hands and feet are caused by an 
insufficient supply of arterial blood to the 
extremities. If circular garters are worn, 
or if stockings, shoes, and gloves are worn 
very tight, they will interfere with the cir- 
culation of the blood to the extremities. 
Insufficient exercise and anemia are also 
reasons for this condition. 

The treatment consists in briskly rubbing 
the hands and feet with cold water, followed 
by dry massage. Walking or jumping for 

[272] 



HICCUP 

several minutes will stimulate the circu- 
lation. 

If the child is anemic an iron tonic will 
be necessary. "Warm drinks, such as milk, 
broth, or gruel may be given every three 
or four hours. 

HICCUP 

Hiccup is due to a spasm of the dia- 
phragm. It is usually provoked by gas or 
by something that has been swallowed 
which irritated the lining of the stomach. 
Cream and foods rich in fat frequently 
cause hiccup. 

A tight-fitting abdominal bandage will 
frequently check the spasm. One-fourth tea- 
spoonful of bicarbonate of soda in a teacup- 
ful of warm water may be repeated every 
half-hour until the spasm is controlled. 

If the spasm persists in spite of this 
treatment try firm pressure with the thumb 

[273] 



HEALTH-CARE OF THE GROWING CHILD 

s 

over the stomach immediately under the 
breast-bone. This firm pressure should be 
continued for at least one minute. 

FOREIGN BODIES IN THE EAR 

Bugs, insects, beads, and other foreign 
bodies will sometimes accidentally lodge in 
the ear. Most objects can be dislodged by 
dropping in the ear a few drops of warm 
sweet- or olive-oil. If the foreign body can 
not be dislodged by this means, place the 
child in a sitting posture, and irrigate the 
ear with one quart of warm water, using a 
fountain-syringe and glass nozzle. The bag 
should be hung no higher than two feet 
above the child's head. 

Do not probe the ear with a hairpin or 
any sharp instrument, but take the child to 
a physician if the foreign body is not easily 
dislodged. 

[274] 



EAEACHE 

EARACHE 

In the back of the throat on each side near 
the tonsils is an opening leading into the 
middle ear. This is called the Eustachian 
tube. Pus-germs from the nose and throat 
frequently enter and set up an inflammation 
resulting in an abscess. We should always 
bear in mind the danger of an extension of 
the catarrhal inflammation from the back 
of the nose and throat into the middle ear, 
when children suffer with tonsillitis or ca- 
tarrhal or influenzal fevers. 

When cold in the head or catarrh in the 
nose and throat persists a long time, or if 
they constantly recur, it is better not to ex- 
periment with home remedies but to have 
the child carefully examined by a physician 
to determine the origin of the trouble. In 
nine cases out of ten adenoids will be re- 
sponsible for the frequent colds. Shall we 
let earache and ear-discharge continue and 

[275] 



HEALTH-CARE OF THE GROWING CHILD 

cause worry when a simple operation devoid 
of danger can cure this trouble 1 ? 

Violent blowing of the nose may result 
in earache. A catarrh will frequently ex- 
tend through the nose and throat and give 
rise to earache. Earache without fever 
need occasion no alarm. Earache is an 
early symptom of measles. 

Warm olive-oil may be dropped into the 
ear, and the ear plugged with cotton. A 
warm water-bag should be placed over the 
ear. Gargling the throat with warm salt 
water, one-half teaspoonful of salt to a 
cup of warm water, every fifteen minutes is 
beneficial. If the child is not relieved by 
this simple means a careful examination of 
the ear must be made by the physician to 
determine the cause of the trouble. 

A simple catarrh of the middle ear if 
neglected may extend to the mastoid cells 
causing inflammation which may prove fa- 

[276] 



PINKEYE 

tal. An early incision in the drum will fre- 
quently prevent a mastoid inflammation. 

PINKEYE 

This infections disease is caused by a 
germ. The blood-vessels of the eye swell. 
Because of the number of engorged blood- 
vessels the eye assumes a pink appearance, 
hence the name pinkeye. The eyelids have 
a discharge which will frequently glue them 
together so that the eye can not be opened 
after the night's rest. 

Owing to the contagious nature of this isolation 
disease the patient should be isolated and 
all cloth or cotton coming in contact with 
the eyes should be burned. Towels should 
be boiled after being used, so that all germs 
are destroyed. The eyes should be pro- 
tected with smoked glasses or the child kept 
in a darkened room. Eeading should be 
prohibited. The heat and smarting in the 

[277] 



HEALTH-CAKE OF THE GKOWING CHILD 

eyeballs can best be relieved by the appli- 
cation of gauze saturated with warm boracic 
acid solution which should be changed every 
five or ten minutes during the day. At 
night borated vaseline applied to the eyelids 
will prevent them from sticking together, 

STIES 

This is a very common infection and 
occurs on the upper and lower eyelids. 
The application of lukewarm lead- water on 
gauze covered with oiled silk and bound on 
with a handkerchief quickly relieves. The 
dressings should be changed once or twice 
every hour. If pus forms and the lid is 
very much swollen, it may be necessary, in 
rare instances, to sterilize a needle by hold- 
ing it in an alcohol flame and open the head 
of the pustule to let the pus out. 



[278] 



EEVEK-SOKES 

TRACHOMA 

This is a highly contagions disease which 
appears as a number of small elevations 
nnder both eyelids. Children contract the 
same in schools or wherever crowded to- 
gether. 

Medical inspectors in schools always 
evert the eyelid to look for this infection. 

The illustration shows the type of the 
disease most common among schoolchil- 
dren. Every mother can with care learn to 
detect it. 

Severe complications may follow if these 
cases are neglected. The treatment is too 
complicated for any mother to attempt. 

FEVER-SORES 

When the stomach is deranged or food 
ferments and stagnates in the intestine we 
will have fever. After the fever is over 
blisters will be seen in the mouth or gums 

[279] 



HEALTH-CAKE OF THE GKOWING CHILD 

and especially around the lips. They are 
the external manifestation of the poison 
generated by the inflammation within the 
body. These sores are frequently found 
on the body as well as on the face. 

One or two teaspoonfuls of rhubarb and 
soda mixture can be given every three hours 
for two days. A paste consisting of bicar- 
bonate of soda and cold water is cooling and 
reduces the swelling. It should be rubbed 
into the sore twice a day. 

Camphorated vaseline or camphorated ice 
is soothing. Neither meat, eggs, nor cereals 
should be given for three days. The diet 
should consist of milk, fruit, and fresh vege- 
tables. 

INJURIES 

Bruise or cut If a child falls the injury may result in 
a black and blue mark known as a bruise. 
If the skin is broken the wound should be 

[280] 




Trachoma of both Lids. A serious eye- 
trouble. Very contagious. 



INJUEIES 

washed with absorbent cotton dipped in 
boiled water. No ordinary house wool 
should be used, nor should cotton be used 
that has been exposed to dust or to the air. 
Sealed package cotton must be used. If 
there is bleeding, moisten the cotton with 
peroxid, using one teaspoonful of peroxid 
to one teaspoonful of boiled water. 
If there is swelling or redness, which is swelling or 

Inflammation 

inflammation, apply gauze saturated with 
diluted cold lead-water. In the absence of 
lead-water, gauze may be saturated with 
witch-hazel or with plain iced water. If 
dirt or dust has entered the wound it should 
be washed with a 1 to 5000 bichlorid solu- 
tion. There is always danger of infection 
from germs that enter the lacerated skin. 
In this way erysipelas or tetanus germs may 
produce fatal results. 

If the wound is infected through im- 
proper treatment and fever develops there 

[281] 



HEALTH-CAKE OF THE GROWING CHILD 

is danger of blood-poisoning. Do not risk 
a child's life by experimental antisepsis, 
and, having given first aid to the injured, 
call a physician. 

Any person handling a wound, no matter 
how slight, must see that the hands are 
thoroughly scrubbed and the finger-nails 
absolutely clean. 
Bums Scalding the skin with hot water or steam 

will produce blisters and redness of the 
neighboring parts. If the burn is mild the 
blisters should be opened with a clean nee- 
dle, and the loosened skin removed with 
sterilized cuticle-scissors. Apply linseed- 
oil and lime-water in equal parts. If the 
linseed-oil and lime-water are not at hand, 
cold cream, corn-starch powder, flour, or 
stearate of zinc may be thickly sprinkled 
over the burn and covered with crossed 
strips of oiled silk, over which gauze and a 
bandage should be placed. The dressing is 

[282] 



INJURIES 

to be changed at least once a day, the same 
treatment being carried out each time. 

If a splinter becomes imbedded in a splinters 
child's flesh it should be picked out with a 
sharp needle. To sterilize the needle, pour 
five or ten drops of alcohol in a saucer in 
which the needle is placed, then set fire to 
the alcohol. With this sterilized needle pick 
out the splinter, beginning at the point of 
entrance. Saturated boric acid solution 
should then be applied overnight. 

Children will often miscalculate distances Fan or s PI 
and cause painful though not dangerous 
wounds by a fall or misstep from a car, 
curb, or any height, and especially in scaling 
fences. 

The treatment consists in having the child 
rest as much as possible. Apply an ice-bag 
during the day. At night saturate a piece 
of gauze with tincture of arnica and apply 
to the affected part. A tight-fitting ban- 

[283] 



HEALTH-CAKE OF THE GKOWING CHILD 

dage over the wet gauze will support the 
affected parts and bring relief. 

As a rule a sprain of this character will 
last several days ; if however the pain con- 
tinues it may be necessary to call a physi- 
cian to determine the nature of the injury. 
to stop If a child is cut and blood spurts like a iet 

Bleeding r ° 

an artery has been cut. If the blood oozes 
and is bluish-red in color, a vein has been 
severed. A clean linen handkerchief should 
be tied around the part and a strip of clean 
linen or sterile gauze of half a dozen thick- 
nesses should be pressed over the wound. 
Styptic cotton or styptic wool, if handy, 
can be applied directly to the bleeding, 
using a tight bandage or handkerchief to 
hold it in place. 

When arteries are cut it may be necessary 
to tie them. In such a case call a physician. 



[284] 



NOSEBLEED 

NOSEBLEED 

Violent exercise or injury to the nose will 
sometimes cause nosebleed. Many children 
will suddenly have a flushed cheek and asso- 
ciated therewith nosebleed. There is a de- 
cided difference between nosebleed of this 
character and nosebleed resulting from a 
swelling called a polypus in the nostril. Polypus 
In the latter case a swelling exists, the nos- 
tril is obstructed, and there is difficulty in 
breathing. There will also be very fre- 
quently recurring nosebleed. 

To check nosebleed ice-cloths or a piece 
of ice wrapped in cheese-cloth should be 
held at the root of the nose between the 
eyes. Firm pressure on the upper lip under 
the nostrils for from ten to twenty seconds 
will sometimes check the bleeding. 

The child should be placed in an upright 
position, and the feet immersed in hot 
water. Styptic or plain absorbent cotton 

[285] 



HEALTH-CAKE OF THE GROWING CHILD 

may be used to plug the nostril. Small bits 
of cracked ice may be swallowed. No warm 
food should be given. 

If the attacks recur frequently, a physi- 
cian should be called to determine the cause. 
Constitutional treatment may be necessary. 
It is very important to learn if the child is 
a " bleeder.' ' This condition has been re- 
ferred to in the article on Operations in 
Children. 

WORMS 

Worms enter the body chiefly through 
food. The most common form of worm is 
the pinworm or threadworm. We also fre- 
quently see the roundworm. Older children 
are more subject to the tapeworm, 
pinworm The pinworm is usually found in the stool 

mixed with a catarrhal discharge from the 
bowels. Children so affected are nervous, 
restless, and have an itching around the 

[286] 



WOKMS 

anus. They are uneasy and do not sit long 
in one place. 

When there are very many worms, they 
disturb the nervous system, so that fre- 
quently their presence has been known to 
cause convulsions. In little girls these 
worms will frequently crawl from the rec- 
tum into the vagina. Many cases of vulvitis 
and vaginitis, consisting of an inflammation 
of the external genitals, are thus caused by 
worms. Their presence will cause itch- 
ing which may ultimately lead to mastur- 
bation. 

These worms resemble spool-cotton and 
can easily be removed by giving an enema 
of a teaspoonful of salt to four ounces of 
water twice a day. One grain of santonin 
and one-fourth grain of calomel should be 
given at bedtime for three successive nights, 
and each morning two teaspoonfuls of rhu- 
barb and soda mixture should be given. 

[287] 



HEALTH-CARE OF THE GROWING CHILD 

Compound licorice-powder may be substi- 
tuted in one-half teaspoonful doses. 
Roundworm This worm is reddish or reddish-yellow 
and from five to ten inches long. It is 
found in the smaller intestines in children 
between the second and tenth years. Some 
children may have five or six, others a 
dozen or more. I have seen these worms 
passed with the stool. Occasionally they 
are vomited with the food. Frequently their 
presence is not associated with any definite 
symptom. They may cause restlessness and 
itching of the anus, grinding of teeth, colic, 
or diarrhea. The children have restless 
nights and frequently complain of pain in 
the stomach or abdomen. Such children are 
not able to locate the exact spot where the 
abdomen hurts. They will have a pain on 
the left side one day and ou the right side 
the next day. They are sensitive, dissatis- 
fied, and hysterical. 

[288] 



WOEMS 

The eggs of these worms can be detected 
in the stool, and as long as they are present 
more worms should be suspected, even 
though a dozen or more have been passed. 

One of the best remedies is the oil of che- 
nopodium, five drops on sugar, three times 
a day for a child ten years old. Eepeat the 
dose on the following day. On the third 
day give a teaspoonful of compound lico- 
rice-powder. If this is effectual repeat the 
treatment three times, at intervals of ten 
days. 

Tapeworm enters the body by means of Tapeworm 
food containing the larvae or eggs. The 
eggs are found in pork, in beef, and in fish. 
A worm develops in about three months. 
When the terminal segments are mature 
they separate and are discharged in the 
stool. As each segment contains both male 
and female organs, each one is capable of 
regenerating a whole worm. For this rea- 

[289] 



HEALTH-CARE OF THE GROWING CHILD 

son the treatment of tapeworm will never 
be successful until the head and every seg- 
ment has been expelled. Tapeworms are 
estimated to live from ten to twenty and 
possibly thirty years. 

The beef tapeworm is most frequently 
found in children. It has four suckers, a 
square head, and no hooks. Eaw beef may 
contain the eggs of the worm. 

The pork tapeworm is rarely found in 
children. The head has four suckers sur- 
rounding which there is a circle of about 
twenty-six hooks. The length of the worm 
varies from ten to fifty feet. 

In older children we will notice colic, 
restlessness, and foul breath. In spite of 
an abnormally large appetite the body is 
poorly nourished and sometimes wastes. 
Many of these cases have been supposed to 
suffer with tuberculosis. 

The presence of the worm is easily de- 

[290] 



WOEMS 

tected by the large white segments of the 
worm that can be seen in the stool. These 
segments are white, flat objects resembling 
a piece of tape. 

The expulsion of the worm is difficult. 
Even though the body may have been ex- 
pelled, unless the head is dislodged and re- 
moved the worm will grow and redevelop. 

The treatment should be left in the hands 
of a physician. It consists in dieting with 
salt herring, onions, and garlic, which sick- 
ens the worm. This diet is followed by a 
large dose of felix mas. The dose, and fre- 
quency of the same, and danger of giving 
an overdose of this specific drug are too 
important for the average mother to un- 
dertake ; hence the physician should be con- 
sulted. 

In the South, and occasionally in the Hookworm 
North, hookworm exists. The worm enters 
the system through the soles of the feet and 

[291] 



HEALTH-CAKE OF THE GKOWING CHILD 

finally lodges in the intestinal tract. The 
worms produce a profound anemia and pale- 
ness of the skin. There is swelling of the 
feet and ankles, and pufiiness of the face. 
There is loss of weight. In the stool the 
eggs of the hookworm can be found. If we 
are living in the locality where hookworm 
exists and the child shows the above named 
symptoms, no time should be lost in placing 
the child under the care of a competent phy- 
sician. 

BED-WETTING 

This is a very common occurrence in 
childhood. In some cases it is due to indif- 
ference on the part of the child. In other 
cases it is due to an irritation or weakness 
of the bladder-muscles which do not retain 
the urine but allow it to trickle away. Many 
children wet by day as well as by night. 
Local irritation, such as a tight foreskin, 

[292] 



BED-WETTING 

very acid urine, adenoids, or general weak- 
ness of the bladder are the common causes 
in boys as well as in girls. 

If bed-wetting follows an attack of in- 
fluenza or if it follows diphtheria, then 
probably paralysis of the bladder-muscles 
may be the reason for the same. 

The treatment consists in giving small 
quantities of liquids at supper. Cold spinal 
douches should be given morning and even- 
ing. The foot of the bed should be elevated. 
Meat should be allowed only every other 
day. Drugs such as strychnin must not be 
given without the advice of a physician. 
Toning up the muscles with electricity is 
frequently serviceable. The urine requires 
chemical examination, to see if too much 
acid may not be the cause of the bed-wet- 
ting. 



[293] 



HEALTH-CAKE OF THE GROWING CHILD 

RETENTION OF URINE 

The retention of urine is a serious matter. 
The healthy child should pass about one 
quart of urine in twenty-four hours, but 
this quantity may vary with the amount of 
liquids taken. When solid food is taken 
there will be less urine passed than when 
liquid food is taken. During fever and in 
diseased conditions the kidneys sometimes 
act sluggishly. 

Fifteen drops of sweet spirits of niter 
may be given in water and repeated three 
times a day. If the kidneys do not respond 
and the urine is still suppressed, a warm 
hip-bath should be given for three minutes. 
Dry cups may be applied over the region 
of the kidneys once or twice a day. A warm 
water-bag may be applied to the small of 
the back or the abdomen. If the child does 
not respond to this treatment a physician 
should be called. 

[294] 



LEUCORRHEA 

LEUCORRHEA 

A white milky discharge or a yellowish- 
white discharge from the female genital 
tract is known as leucorrhea. It may be the 
result of a general systemic weakness. It 
may also be due to threadworms crawling 
from the rectum into the vagina. Scratch- 
ing and rubbing so-called thigh-friction 
will irritate and inflame the parts, giving 
rise to leucorrhea. 

After measles, diphtheria, influenza, and 
especially scarlet fever, leucorrhea is fre- 
quently noted. It may then be considered 
as a complication resulting from the disease 
with which the child suffered. Leucorrheal 
discharges are occasionally carried from the 
mother or nurse to the child by sleeping in 
the same bed. 

This condition should not be neglected, 
and modesty should not prevent the mother 
from taking the child to the family physi- 

[295] 



HEALTH-CAKE OF THE GROWING CHILD 

cian for treatment. Now and then a child 
may be infected by using a dirty toilet-seat 
in a public school or hotel. 

If the discharge persists in spite of mild 
treatment a complete laboratory examina- 
tion of the discharge should be made to 
determine its nature and the treatment re- 
quired. Sitz baths of two teaspoonfuls 
alum and four gallons water are beneficial. 

If in spite of local irrigations of alum- 
water leucorrhea persists, tonics such as 
iron or codliver-oil should be given. A 
change of air from the city to the country 
is desirable, preferably to the sea, for sea- 
baths will prove beneficial. 

Every mother should know that there is 
great danger of infecting the eyes. She 
should instruct the child to thoroughly wash 
its fingers after going to the toilet. A light 
pad should be worn, and changed several 
times a day, and burned after using. 

[296] 



FISSURE OF THE ANUS 

The child should sleep alone. The dis- 
charge may be communicated to others. 

FISSURE OF THE ANUS 

This is a painful condition of the rectum 
that is occasionally met with in children. 
They will complain of pain during stool. 
Now and then the fissure will bleed during 
a movement. 

On separating the folds of the anus (out- 
side rectum) one or more grooves of in- 
flamed flesh will be seen. Into these fissures 
particles of stool enter and cause irritation. 
Hardened lumps of stool will frequently be 
the cause of fissures while passing through 
the anus. 

The intense itching causes the child to 

scratch by day as well as during the night. 

If the fingers or finger-nails are not clean 

an infection may take place giving rise to 

an abscess. 

! 

[297] 



HEALTH-CAKE OF THE GKOWING CHILD 

The treatment consists in keeping the 
parts clean, for which purpose a bath of 
soap-water applied with absorbent cotton 
after each movement of the bowels is re- 
quired. Zinc-salve or cold cream should 
then be applied. At times fissures of the 
anus will bleed and require cauterizing with 
nitrate of silver. 

A bland diet, consisting of milk, cheese, 
fruit, vegetables, and bread and butter, 
should be given. Meat, fish, eggs, and cere- 
als should be omitted from the diet until the 
fissures have all healed. 

POISONS AND ANTIDOTES 

It is self-understood that no mother or 
nurse should take the responsibility of 
caring for a child that has been poisoned 
or in which symptoms of poisoning are sus- 
pected. Rapidity in eliminating the poison 
may be the means of saving the child's life; 

[298] 



POISONS AND ANTIDOTES 

hence in every case of poisoning a physician 
should be summoned. Certain symptoms 
can always be noted by a physician which 
may be overlooked by the layman. For in- 
stance, the condition of the heart, the pulse, 
the pupils, the extremities, whether or no 
they are rigid, cold hands and feet, and con- 
vulsions, all of these symptoms indicate the 
condition of the system. 

Until the physician arrives, no time 
should be lost and the following suggestions 
carried out : Accidents in which poison has Emetics 
been swallowed usually call for the speedy 
production of vomiting. Poisons act very 
quickly unless they are neutralized or di- 
luted. If possible a teaspoonful of ipecac 
should be given and repeated every five 
minutes until vomiting is produced. 

If an acid has been swallowed olive-oil or 
one teaspoonful of bicarbonate of soda in a 
teacup of water should be given. 

[299] 



HEALTH-CAKE OF THE GKOWING CHILD 

Warm or cold milk if given soon after 
any poison has been swallowed will dilute 
the same. 

If an overdose of medicine such as pare- 
goric or laudanum has been given, give 
half a teacupful of black coffee as soon as 
possible. 

If a liniment or some patent medicine has 
been given by mistake, give the child a half 
cup of black coffee and fifteen minutes later 
a teaspoonful of sirup of ipecac. 

If carbolic acid or oxalic acid has been 
swallowed give one or more wineglassfuls 
of olive-oil. 

If the child is drowsy from an overdose 
of paregoric or a sleeping-mixture, give a 
mustard foot-bath by using a tablespoonful 
of mustard to a pail of warm water, bathing 
the feet two minutes. Also give a cup of 
coffee to which two teaspoonfuls of whisky 
have been added. 

[300] 



POISONS AND ANTIDOTES 

A child that is drowsy should be sup- 
ported under its arms and made to walk in 
the open air in order to revive him. A cold 
cloth to the head and sponging the face with 
Cologne or Florida water, or the inhalation 
of ammonia-vapor will help to revive the 
child. 

If in spite of this treatment the child 
remains drowsy, an injection of a pint of 
water containing one teaspoonful of table 
salt should be injected into the rectum at a 
temperature of 115 degrees. If possible a 
high enema should be given, the soft rubber 
tube being inserted six to eight inches. 



[301] 



APPENDIX 



[303] 



Appendix 

FOOD RECIPES 

Milk is frequently used as a drink by 
school-children. If the milk is certified or 
pasteurized it is safe, not otherwise. My 
advice therefore is to give school-children a 
bottle of pasteurized milk and keep it warm 
in a thermos bottle until lunch hour. 

If the source of the milk is unknown it is 
safer to steam the milk twenty minutes or, 
if the child is not constipated, the milk may 
be brought to the boiling-point. 

When milk has been steamed it should be 
cooled rapidly and placed in a refrigerator 
until it is used. If milk is exposed to the 
air and not properly cooled in a refrigera- 
tor it will easily be contaminated. 

The danger in milk consists in the ease 
with which tuberculosis, typhoid, or diph- 

[305] 



Milk 



HEALTH-CARE OF THE GROWING CHILD 

theria germs can be conveyed by its use to 
the healthy child. These germs multiply 
and thrive in raw milk. They are destroyed 
and lose their vitality when milk is boiled 
or steamed, 
peptonized Peptonizing powders are digestive agents 

sold in glass tubes or in tablet form. They 
are composed of pancreatin and bicarbonate 
of soda. The contents of a peptonizing 
tube or a tablet should be dissolved in a 
tablespoonful of cold water, and a quart 
of milk added. Place this milk containing 
the powder in a pot of hot water at a tem- 
perature of about 110 degrees, leaving it 
there for ten minutes. The milk must then 
be quickly brought to the boiling-point, 
and placed in a pot of cold water, to pre- 
vent further peptonization. Bringing the 
milk rapidly to a boil will kill the digestive 
ferment, thus avoiding a bitter taste. 
For each large cup take a teaspoonful of 

[306] 



FOOD EECIPES 

cocoa and a teaspoonful of sugar ; mix to a cocoa 
paste with a little boiling water or milk ; add 
balance of milk, or milk and water, as rich- 
ness is desired. Boil one minute, as boiling 
improves the flavor. 

Take the beaten yolk of one egg and add Yoik of E gg 

Lemonade 

to it the juice of one-half lemon. Let stand 
five minutes, thus drawing off the raw taste 
of the yolk of egg. Add one teaspoonful of 
sugar and eight ounces of water. 

Take the juice of one orange and one Aibumenized 

Orangeade 

ounce of water, and insert an egg-whisk. 
When the orangeade is in full agitation 
add slowly the white of egg. Continue the 
whisking for one or two minutes. Add one- 
quarter teaspoonful of sugar. 

Heat six ounces of milk to a temperature E gg -No g 
of 150 degrees, but do not allow it to boil. 
When cold beat up a fresh egg in a tumbler 
with some sugar, add a few drops of vanilla, 
and fill up the tumbler with warm milk. 

[307] 



HEALTH-CAKE OF THE GROWING CHILD 



chicken Broth Cut up a small chicken, put bones and all 
with a sprig of parsley, salt, one tablespoon- 
ful of rice, and a crust of bread, in a quart 
of water, and boil for one hour, skimming 
it from time to time. Strain through a 
coarse colander. 

Mutton soup Cut up fine two pounds of lean mutton, 
without fat or skin. Add one tablespoonful 
of barley, one quart of cold water, and a 
teaspoonful of salt. Let it boil slowly for 
two hours. If rice is used in place of barley, 
soak the rice in water overnight. 

Beef- juice Expressed beef -juice is obtained by 

slightly broiling a piece of lean beef and 
expressing the juice with a lemon-squeezer. 
One pound of steak yields two or three 
ounces of juice. This is flavored with salt 
and served cold or warm. Do not heat to 
coagulate the albumin. It is very nutri- 
tious and well-taken. 

junket Add one teaspoonful of liquid rennin or 

[308] 



FOOD KECIPES 

one junket tablet to one pint of milk. Mix 
and heat until the steam rises. Pour into 
cups and set aside to cool. Flavor with 
vanilla or pineapple if desired. 

Or to a bowl containing eight ounces of 
cool milk add one teaspoonful of pepsencia 
(Fairchild). Mix thoroughly. Place bowl 
in pan of boiling hot water for two minutes. 
Remove and let stand until jellied. 

Beat one egg to a froth and sweeten with junket of 

& ° Milk and Egg 

two teaspoonfuls of white sugar. Add this 
to one-half pint of warm milk ; then add one 
teaspoonful of pepsencia (Fairchild) ; let 
it stand until it is curdled. 

Take one pint of milk and mix with it Arrow Root or 

Corn-Starch 

two tablespoonfuls of corn-starch ; flavor to v***™* 
taste, then boil the whole eight minutes. 
Allow it to cool in a mold. 

Break one egg into a teacup and mix custard 
thoroughly with one teaspoonful of sugar. 
Add milk to nearly fill the cup, mix again, 

[309] 



HEALTH-CAKE OF THE GKOWING CHILD 



and tie over the cup a small piece of linen. 
Place the cup in a shallow saucepan half 
full of water and boil for ten minutes. 
Rice pudding Boil a teacupful of rice, drain off the 
water; add a tablespoonful of cold butter. 
Mix with it a cupful of sugar, a quarter 
teaspoonful each of nutmeg and cinnamon. 
Beat up four eggs very light, whites and 
yolks separately ; add them to the rice, and 
gradually stir in a quart of sweet milk. 
Butter a pudding-dish, turn in the mixture, 
and bake one hour in a moderate oven. 

Same as above recipe, sago being sub- 
stituted for rice. 

Take one pint of milk, two tablespoonfuls 
of tapioca, two tablespoonfuls of sugar, one 
saltspoonful of salt, and two eggs. 

Wash the tapioca. Add enough water to 
cover it and let it stand in a warm place 
until the tapioca has absorbed the water. 
Then add the milk and cook in a double 

[310] 



Sago Pudding 



Tapioca 
Pudding 



FOOD EECIPES 

boiler, stirring often until the tapioca is 
clear and transparent. Beat the yolks of 
the egg. Add the sugar and salt and hot 
milk. Cook until it thickens. Eemove from 
the fire. Add the whites of the eggs, beaten 
stiff. When cold add one teaspoonful of 
vanilla. 

Thoroughly clean two feet of a calf, cut cairs Foot 
into pieces, and stew in two quarts of water 
until reduced to one quart. When cold, take 
off the fat and separate the jelly from the 
sediment. Then put the jelly into a sauce- 
pan with the whites of four eggs. Boil for 
a quarter of an hour, cover it, and let it 
stand for a short time. Strain while hot 
through a bag into a mold. Flavor with 
lemon. 

Cut a young chicken into small pieces, put chicken jeiiy 
in a saucepan with three pints of water. 
Cook slowly, removing the grease from top 
constantly. Allow it to cook about five 

[311] 



HEALTH-CAKE OF THE GROWING CHILD 



Coddled Egg 



hours. Season with salt, pepper, celery, 
and parsley. Strain. When cool remove 
every bit of grease. Serve either hot or 
cold. 

Cover a fresh egg with boiling water and 
let it stand five minutes. Pour off this 
water j and again cover with boiling water, 
and let stand five minutes. Eemove from 
shell, add a pinch of salt, and serve. Pre- 
pared in this manner the egg will be me- 
dium soft, the yolk and white both being 
of a jelly-like consistency, 
poached Egg Drop eggs into hot, well-seasoned broth 
or milk instead of into water. Be careful 
that the yolks do not break. When heated 
to a jelly-like consistency, remove and serve 
on toast. Strain enough of the broth or 
milk over them to moisten the toast. 

All cereals should be steamed in salted 
water, at least two hours, in a double boiler. 
Serve with sugar and cream. 

[312] 



Cereals and 
Gruels 



LOCAL KEMEDIES 

If cereals are prepared in a fireless cooker 
they may remain in the cooker overnight. 

Scraped beef is prepared by scraping scraped Beef 
with a dull silver knife a piece of raw lean 
round steak. Season with salt and a little 
pepper. Serve on toast or cracker. 

If preferred the beef may be slightly 
broiled or heated. 

LOCAL REMEDIES 

A sponge-bath is a simple general wash- sponge-Bath 
ing of the body with sponge or wash-cloth 
and warm water. The child should be un- 
dressed completely and put between blan- 
kets. The sponging must be performed 
rapidly and under cover, one part at a time, 
and drying it before going to another, fol- 
lowing the order : face, arms, chest and ab- 
domen, back, legs. 

Cold sponging is sometimes ordered to cow sponge 
reduce fever. A cotton blanket is used. 

[313] 



HEALTH-CAKE OF THE GKOWING CHILD 

One part of alcohol is added to two parts of 
water, at room temperature. The sponge 
is saturated and drawn lightly and slowly 
over the parts. The bath may last from 
fifteen to twenty minutes and may be re- 
peated every hour if the fever is high. 

In eruptive fevers no sponging should 
be done until a physician has been con- 
sulted. 
Tub-Bath No tub-bath is given during illness unless 

ordered by a physician. It is sometimes 
ordered to bring out the rash of measles 
or scarlet fever. 

To allay nervous excitement and induce 
sleep, the bath should be given at 100 
degrees. The child may remain in the 
bath for from five to ten minutes, be dried 
quickly, and put to bed. 

Cold tub-baths and hot tub-baths are 
never given without a physician's order. 
shower-Bath The shower-bath is an excellent nerve- 

[314] 



LOCAL EEMEDIES 

and muscle-stimulant and may be used fre- 
quently, especially during the summer. 

A cold shower-bath should not be given 
unless ordered by a physician. 

In cases of nephritis and to induce per- Bianket-Bath 

or Hot Pack 

spiration a blanket-bath or hot pack is some- 
times ordered. The child is wrapped in 
blankets wrung out in hot water, and cov- 
ered with several dry blankets. The pack 
is usually removed in one hour unless the 
patient falls asleep. On removing the pack, 
the body must be dried with a quick al- 
cohol rub, being careful not to expose the 
child. 

A mustard-bath is a powerful stimulant Mustard-Bath 
and is sometimes ordered when a child is 
rapidly failing from any cause. 

It is sometimes ordered to bring out a 
rash in eruptive fevers. Mustard is added 
in the proportion of one heaping teaspoon- 
ful to one gallon of warm water. The child 

[315] 



HEALTH-CAKE OF THE GROWING CHILD 

remains in the bath from two to three 
minutes. 

soda-Bath The soda-bath is given for hives and 

similar skin affections. It is usually given 
in the form of a sponge-bath, in the propor- 
tion of one tablespoonful of bicarbonate of 
soda to one gallon of water. 

salt or Tonic The salt-bath when given as a tonic bath 

Bath 

should be tepid or cool and followed by a 
brisk rubbing. One heaping tablespoonful 
of salt is dissolved in one gallon of water. 

suifur-Bath The sulfur-bath is given in rheumatism 

and to allay itching in various skin-affec- 
tions. Twenty grains of sulfid of potas- 
sium should be dissolved in a gallon of water 
at a temperature of 100 degrees. A wooden 
tub should be used, as the sulfur tarnishes 
metal. 

Bran- and Bran- and oatmeal-baths are given to 

Oatmeal-Baths 

soothe an irritated skin. They are made by 
tying one pound of bran or oatmeal in a 

[316] 



LOCAL EEMEDIES 

cheese-cloth bag, scalding it for ten minutes, 
and squeezing out the milky fluid into a tub 
of lukewarm water. The child remains in 
the bath ten minutes. 

Wet compresses are frequently ordered wet compress 
to reduce inflammation, as in the cases of 
sore throat. They consist of thick cloths 
wet with water and applied to some part of 
the body. 

A warm compress is made by folding a warm or Hot 

Compress 

piece of flannel several times, placing it in 
an open towel, dipping it into boiling water, 
and wringing out thoroughly by twisting 
the towel. After testing it against the 
cheek, it is applied to the patient, covered 
with a dry towel or piece of oiled silk. 

A cold compress is sometimes ordered to coid compress 
relieve a congested headache, for inflamma- 
tion or for sprains. It is made of several 
layers of linen dipped in cold water, wrung 
out, and applied to the affected part. 

[317] 



HEALTH-CARE OF THE GROWING CHILD 

If an intense cold is desired, two parts 
of ice-water and one part of alcohol are 
used. The compresses are changed every 
few minutes. 

ice-Bag An ice-bag is sometimes used instead of 

the iced cloths. The ice should be shaved 
and packed in the ice-bag. If cracked ice 
is used, a cup of hot water should be poured 
over the ice to melt off the sharp edges. The 
rubber ice-bag should never be filled more 
than half. As much air as possible should 
be expelled by twisting the top of the bag 
before applying the screw-cap. 

Dry Heat Dry heat is most conveniently applied by 

means of hot-water bags. These rubber 
bags may be bought of all sizes, from three 
to four inches long, which are so useful in 
earache or toothache, to the large ones 
holding two to three quarts. 

If one wishes to apply heat to the feet, 
the bag may be filled with hot water. If the 

[318] 



LOCAL KEMEDIES 

bag is to be applied to the abdomen where 
weight or pressure is to be avoided it should 
be filled to one-half its capacity, and all the 
air pressed out before putting in the stop- 
per. Screw in the top very firmly, being 
careful to have the rubber washer in place. 
Evert the bag, to see if there is any leak. 
Before applying the bag cover it with a 
piece of flannel securely sewed in place, or 
slip it into a flannel bag which can be se- 
curely tied. These rubber bags must be 
frequently tested or examined, as they 
sometimes break and scald the patient. 

In cases of backache there is nothing so 
comforting as a hot- water bag. In headache 
and many cases of toothache one of the 
small bags, filled with ice-cold water and 
applied to the cheek, the head, or the back 
of the neck, will give great relief. 

In an emergency, bags of salt, bricks, or 
smoothing irons may be heated in the oven, 

[319] 



HEALTH-CAKE OF THE GKOWING CHILD 

wrapped in flannel, and applied as hot as 
can be borne. 

poultice A ponltice is a soothing remedy of a moist 

mealy nature, applied to an inflammation. 
It is intended to furnish heat, but should 
always be tested against the cheek of the 
nurse before being applied to the child. 

Flaxseed- This is made of flaxseed-meal. The meal 

Poultice 

is first mixed with a little cold water and 
then stirred into boiling water until it is 
of the consistence of mush, after which it 
should be removed from the fire. A layer of 
this about an inch thick is spread on a piece 
of cheese-cloth, the edges folded over and 
secured. 
Mustard- One part of mustard is mixed with four 

Poultice x 

or five parts of flaxseed- or wheat-flour. 
Boiled water is added until it is reduced to 
the consistence of mush. It is then spread 
on cloth and applied directly to the skin. 
If it burns too much a layer of linen can be 

[320] 



LOCAL EEMEDIES 

placed between. It should be kept on until 
the skin is reddened but not long enough to 
blister. 

When a poultice of very light weight is Bran- or h op - 

Poultice 

desired, bran or hops is used. A bran-poul- 
tice is made by sewing the bran in a muslin 
or flannel bag, then heating the whole in the 
oven or wringing it out of boiling water. 
An oiled silk jacket is sometimes ordered oiied suk 

Jacket 

by the physician in cases of pneumonia. It 
should be shaped like a child's sleeveless 
shirt. A layer of cotton is placed between 
a layer of cheese-cloth and one of oiled silk. 
The edges are turned in and the three layers 
basted together. The shoulder-seams or 
straps may be sewed together or tied with 
tapes. The front is closed by means of 
tapes sewed on either side. The jacket is 
worn with the layer of cheese-cloth next to 
the skin. 

To give a simple enema, ordinary suds simple Enema 

[321] 



HEALTH-CAKE OF THE GROWING CHILD 



Camomile- 
Injection 



High Enema 



are made with Castile or glycerin soap and 
warm water, temperature 100 degrees. A 
fountain-syringe to which a nozzle is at- 
tached should be used. Fill the bag with 
the amount of suds ordered (usually one or 
two pints) and anoint the nozzle with vase- 
lin. Open the spring-clasp on the tube 
and allow the air and cold water to escape. 
Gently insert the nozzle into the rectum and 
allow the water to flow in a slow, steady 
stream. The bag should be held about two 
feet above the child's body. The child 
should be encouraged to retain the water 
as long as possible. 

A camomile-injection is given in the same 
manner as a simple enema. Camomile tea 
is used by steeping one tablespoonful of 
camomile-flowers in a quart of boiling water. 

When there is considerable constipation 
the enema will be more successful if given 
in the knee-chest position, that is with the 

[322] 



LOCAL EEMEDIES 

patient resting on the knees and chest in 
bed, the head very low, and nsing a long 
flexible rubber tube on the end of the sy- 
ringe, so that the tube can be inserted six 
or eight inches up into the bowels. This is 
called a high enema. It can also be given 
with the patient lying on the left side with 
knees drawn up. 

Adding olive-oil and glycerin to a suds- on-Enema 
enema will prove effective if the simple ene- 
ma is not sufficient. An ounce of each is 
sufficient to add to a pint of water. 

Sometimes the physician orders an oil- 
enema to be given first and retained for an 
hour, followed by a simple soapsuds-enema. 
In that case four ounces of hot oil are in- 
jected and allowed to work slowly through 
the bowels before giving the simple enema. 

In cases of acute diarrhea, starch-enema starch-Enema 
is sometimes ordered. A starch-enema is 
made by mixing a dessertspoonful of starch 

[323] 



HEALTH-CAKE OF THE GKOWING CHILD 



Stimulating 

Enema 



Nutritive 
Enema 



with cold water into a paste and adding 
three ounces of boiling water. The water 
is then injected and the child encouraged to 
retain it as long as possible. 

Stimulating enemas are given in case of 
shock or collapse and should be very hot, as 
they will be more easily retained. The 
usual amount is one tablespoonful of whisky 
or brandy to four ounces of very hot water. 
Coffee is sometimes used instead of water, 
or it may be given alone. The enema must 
be given high to be retained. 

When the stomach is much disturbed dur- 
ing a severe illness so that food can not be 
digested, or after some operations on the 
mouth or throat, nutritive enemas are given 
to nourish the system. Various formulae are 
used; one of the best is: peptonized milk, 
two ounces, one egg, and a pinch of salt. 
Beef-juice may also be given according to 
the physician's orders. When this is the 

[ 324 ] 






OINTMENTS AND LOTIONS 

only form of nourishment it must be given 
every four or five hours. A simple soap- 
suds enema is necessary onee a day to wash 
out the lower bowel. 



OINTMENTS AND LOTIONS 

Good Mouth-Washes 
To sweeten the mouth before breakfast: 

Thymol lYi grains 

Alcohol 2 ounces 

Borax 15 grains 

Distilled water to make 1 pint. 

For pimples or soreness in the mouth : 

Tincture of myrrh J/2 dram 

Sodium bicarbonate Yl dram 

Chlorate of potassium a pinch 

Distilled water 6 ounces 

Tooth-Powder 

Powdered chalk 1 ounce 

Oil of peppermint 1 drop 

[S25] 



HEALTH-CAKE OF THE GROWING CHILD 

Tooth-Paste 

Powdered white Castile soap. 2]/£ ounces 

Precipitated chalk 2J/g ounces 

Powdered orris-root 24 ounce 

Oil of peppermint J/& fluid dram 

Add glycerin enough to make a paste. 

Sunburn-Lotion 

Glycerin 1 ounce 

Spirits of camphor i/4 ounce 

Boiled water 4 ounces 

Rose-water 4 drops 

Blackheads 

Resorcin 60 grains 

Zinc oxid 120 grains 

Starch 120 grains 

Petroleum 240 grains 

Apply at night. 

Pimples 

Ichthyol 90 grains 

Ether 2J/2 fluid drams 

Alcohol 4 fluid drams 

Dab on spots several times a day. 

[ 326 ] 



OINTMENTS AND LOTIONS 

Dusting Powder for Excessive Perspiration 

Powdered calamine 2 drains 

Florentine orris-root 1 ounce 

Powdered starch 3 ounces 

The parts should first be wiped with alcohol 
before applying the powder. 

Bath-Lotion for Tired Muscles 

Spirits of ammonia 2 ounces 

Spirits of camphor 2 ounces 

Sea-salt V/2 cups 

Alcohol 2 cups 

Put all the ingredients together in a quart bot- 
tle and fill it with hot water. Shake well before 
using. 

Perspiration and Fetor of the Feet 

Orris-powder 1 ounce 

Zinc-oxid 1 ounce 

Talcum powder 6 ounces 

For Dandruff 

Resorcin ; 8 grains 

Castor-oil 1 fluid ounce 

Alcohol 3 fluid ounces 

Peru balsam 5 grains 

Rub in the scalp daily. 
[ 327 ] 



HEALTH-CAKE OF THE GROWING CHILD 

Dry Shampoo 

Very fine white corn-meal .... 20 parts 

Powdered orris-root 1 part 

Sprinkle the powder through the hair. Mas- 
sage the scalp, being sure to rub the powder 
over it. Shake the powder through the long 
hair, letting it stand for half an hour. Remove 
all the meal from the hair by means of a long- 
fibered brush. 

Lotion for Freckles, No. 1 

Compound tincture of benzoin 1 fluid dram 

Glycerin Yl fluid dram 

Rose-water 3 fluid ounces 

Lotion for Freckles, No. 2 

Borax 1 dram 

Dilute acetic acid Yl fluid ounce 

Rose-water Yl fluid ounce 

Apply night and morning. 

Alum Lotion 

Alum 6 drams 

Water 8 fluid ounces 

Alcohol 8 fluid ounces 

To be used as a wash in excessive perspiration 
or if bed-sores are threatening. 

[328] 



INDEX * 



Abdomen, cramps in, 77, 
123, 209, 212, 228 

distended, 120 
Abscess, following measles, 
198 

of anus, 297 

of ear, 160 

of gum, 60 

of lung, 169, 177 
Accidents. See Injuries 
Acidosis causing vomit, 116 
Adenoids, 13, 1^1 

causing earache, 275 

causing rhinitis, 149, 151 
Air, fresh, 12, 38 

in bronchial asthma, 166 

in bronchopneumonia, 169 

in tuberculosis, 176, 178 

in whooping-cough, 181 

impure, 13 

night, 15 
Albuminized orangeade, 307 
Alcoholic sponge bath, 9, 94 
Alcoholic stimulation, 168 
Alum lotion, 328 
Amusements, 24 
Anemia, 38, 46 

caused by intestinal indi- 
gestion, 128 



Anesthetics, 263 

Antidotes for poisons, 298 

Antitoxin, in diphtheria, 191 

in diphtheritic croup, 189 

rash, 232 
Anus, fissure of, 297 

itching of, 286 
Appendicitis, 209 
Appetite, loss of, 90, 113 

loss of, due to adenoids, 
142 

loss of, due to sore throat, 
140 

loss of, in influenza, 159 

loss of, in intestinal indi- 
gestion, 128 

to stimulate, 114 
Arrowroot pudding, 309 
Asthma, bronchial, 164 
Athletics. See Exercise 

for nervous children, 55, 
58 

B 

Backache, 319 

Bad habits, 51, 78 

Bathing, 6 

Baths, alcohol, 9, 313 

blanket, 315 

bran, 316 



* Where more than one reference is given, the number in Italics (for 
example 141) refers to the main article. 

[329] 



INDEX 



Baths, cold, 80, 244, 313 

foot, 300 

in eruptive fevers, 314, 
315 

mustard, 246, 315 

oatmeal, 316 

oatmeal, in eczema, 225 

ocean, 9 

salt, 316 

shower, 314 

shower, cold, 7 

sponge, 313 

sponge, during menstrua- 
tion, 76 

to induce perspiration, 315 

to induce sleep, 10, 314 

to reduce temperature, 313 

to relieve nervousness, 55, 
59, 244, 314 

to stimulate appetite, 114 

tonic, 316 . 

tub, 6, 3U 

warm, 8 

warm, for sleeplessness, 10 
Bed-bugs as disease carriers, 

156 
Bedsores, lotion for, 328 
Bed-wetting caused by ade- 
noids, 142, 145, 292 
Beef-juice, 308 
Beef, scraped, 313 
Belching, 61 
Bicycle riding, 133 
Bites, insect, 222 
Blackheads, lotion for, 326 
Bladder, 4 

weak, 292 
Bleeder, 263 
Bleeding, 263, 281, 284 

from anus, 298 

from nose, 285 

in brain concussion, 249 



Bleeding, in scurvy, 135 
Blindness, from gonorrheal 
infection, 82 

from trachoma of eyelids, 
279 
Blisters, 282 

in mouth, 279 

lotion for, 325 

water, 194 
Blood, examination during 
reduction diet, 110 

poisoning, 281 

test, for malaria, 212 

test for syphilis, 150 
Bones, in rickets, 131 
Bowels, 118 

function of, 3, 43, 122 

loose, 45, 122 

loose, in intestinal in- 
digestion, 128 

training of, 43, 122 
Bowlegs, 131 
Brain, concussion of, 248 
Bran bath, 316 

poultice, 321 
Breasts, development of, 75 
Breath, 60 

in tonsillitis, 147 

sour, 116 
Breathing, correct, 25 

difficult, 164 

in croup, 185 

in diphtheritic croup, 188 

suspended, in convulsions, 
245 
Bronchial asthma, 164 
Bronchitis, 152, 161 
Bronchopneumonia, 166 
Broths, 308 
Bruises, 280 
Brush, hair, 70 

hair, wire, 72 



[330] 



INDEX 



Brush, tooth, 63 
Burns, 282 
from sun, 230 



Calf's foot jelly, 307 
Calomel, to reduce fever, 92 

to relieve congested liver, 
166 
Camomile injections, 127, 

318 
Camp-life, 44, 1^6 
Canned-foods, 135 
Carbolic acid poisoning, 300 
Carelessness, 54 
Carrier of disease, 154, 205 
Catarrh, 148 

intestinal, 10, 37 

of the head, 13, 37 

of the head, causing ade- 
noids, 141 

of the head, causing loss 
of appetite, 113 

syphilitic, 150 
Catarrhal influenza, 159 
Cathartics. See Laxatives 
Cereals, 312 
Cerebrospinal meningitis, 

250 
Characteristics of childhood, 

47 
Chest, deformity of, 145 

flat, 258 

in pleurisy, 152 

wheezing of, 164 
Chest-weight exercise, 29 
Chicken broth, 308 

jelly, 311 

pox, 194 
Chills, in lobar pneumonia, 
170 



Chills, in malaria, 212 
Chorea, 243 
Circulation, 11 
Clothing, 36 

bed, 20 

during exercise, 26 
Coated tongue, 60 
Cocoa, 307 
Coddled egg, 312 
Cold, applications of, 317 

baths, 7 

hands and feet, 27, 212 

in the head, 91, 144, U8 

in the head, a symptom of 
influenza, 159 

in the head, a symptom of 
measles, 150, 196 

prevention of, 6 

shower, 6 

taking, 13 
Colic, 123, 121 
Comb, 71 
Compress, 317 
Concussion of the brain, 248 

causing vomiting, 115 
Condiments, 98 
Constipation, 43, 77, 86, 119 

causing loss of appetite, 
113 

diet in, 97 
Consumption. See Tubercu- 
losis 
Contagious diseases, 154 
Convalescence, 46 
Convulsions, 245 

caused by worms, 287 

in tuberculous meningitis, 
250 
Cooling lotions, 281, 325 
Corn-starch pudding, 309 
Corporal punishment, 53 
Cough, 151 

331] 



INDEX 



Cough, a symptom of in- 
fluenza, 159 

a symptom of measles, 196 

croupy, 185, 187 

in bronchopneumonia, 167 

whooping, 180 
Cramps, 123, 121 

during menstruation, 77 
Crisis, in bronchopneumonia, 
167 

in lobarpneumonia, 171 
Croup, 185 

diphtheritic or true, 187 

false, 185 
Crusted eyelids, 277 
Curiosity, 49 

Curvature of spine, 35, 255 
Custard, 309 
Cuts, 280 



D 



Dandruff, 237 

lotion for, 327 
Deafness caused by adenoids, 

143 
Decayed teeth, 60, 63 
Delirium, 159 
Dentition, 64, 65 
Despondency, 53 
Desquamation, in measles, 
197 

in scarlet fever, 201 
Development. See Puberty 
Diarrhea, 122 

diet in, 112 

in influenza, 159 
Diet, 97 

causing eczema, 224 

causing rickets, 131 

during fever, 92 

during menstruation, 77 



Diet 

for a child over ten years 
of age, 107 

for a child six to ten years 
old, 102 

for a child three to six 
years old, 100 

for a child with weak di- 
gestion, 102 

for a lean child, 97, 108 

for an underweight child, 
108 

for a very fat child, 110 

in constipation, 97, 121 

in diarrhea, 112, 127 

in eczema, 224 

in fever, 112 

in intestinal indigestion, 
128 

in rickets, 132 

in scurvy, 135 

in tuberculosis, 176 

in typhoid, 208 

in whooping-cough, 183 

peculiarities of taste in, 
98 

reduction, 110 
Diphtheria, 190 

antitoxin in, 189, 191 

disinfectant in, 17, 193 

paralysis following, 253 
Diphtheritic croup, 187 
Discharging ear, 144, 154 

nose, 142, 1^8 

vagina, 154, 295 
Discipline. See Punishment 

of nervous children, 57 
Disinfection, 156, 193 

after scarlet fever, 202 
Draughts, 15 
Dreams, 21 
Dry, heat, 318 



[332] 



INDEX 



Dry, shampoo, 328 
Dysentery, 123 

E 

Ear abscess, 160 

Earache, 275 

Ears, bleeding from, 249 

discharging, 144, 154, 198 

foreign bodies in, 274 

syringing of, 274 
Eczema, 223 

Education. See Scho 1 Hy- 
giene 
Egg, coddled, 312 

poached, 312 

yolk of, in lemonade, 307 
Egg-nog, 307 

Elimination, channels of, 3 
Emetics, in croup, 186 

in poisoning, 299 
Emissions, seminal, 78 
Empyema, 177 

following measles, 198 
Enema, 321 

camomile, 128, 322 

high, 322 

nutritive, 324 

oil, 323 

salt water, 301 

soap water, 321 

soda, 125 

starch, 323 

stimulating, 301, 323 

to relieve headache and re- 
duce temperature, 148 
Enlarged glands. See Glands 
Environment, 49 

for nervous children, 57 
Eructations, 61 
Eruption. See Rashes, also 
Eczema 



Eruption, in chicken-pox, 194 
in typhoid fever, 206 

Erysipelas, 226 

Examination of throat, 139 

Exercise, 24 

during menstrual period, 

26, 16 
for the teeth, 62 
for weak ankles, 133 
hanging or heaving, 34 
lack of, resulting in in- 
testinal indigestion, 129 
mat, 32 

pulley-weight, 29 
special, for girls, 32 
wand, 28 

Expectoration, in pneu- 
monia, 170 
in tuberculosis, 172 

Eye-glasses, 258 
smoked, 277 

Eyelids, discharging, 277 
in trachoma, 279 
pustules on, 278 

Eyes, blood-shot, 249, 277 
care of, during measles, 

199 
dark rings under, 80 
dull, in measles, 197 
fixed or staring, in con- 
vulsions, 245 
fixed or staring, in men- 
ingitis, 250 
pink-eye, 277 

sore, following measles, 
198 

F 

Fainting, 270 

Fall, 283 

False croup, 185 



[333] 



INDEX 



Fear, 48 

Feeding. See Diet 

interval, 100 

quantity required, 99 

too much, causing sleep- 
lessness, 20 
Fever, 88 

calomel treatment of, 92 

diet in, 92, 112 

in bronchitis, 161 

in bronchopneumonia, 167 

in influenza, 159 

in lobarpneumonia, 171 

in malaria, 213 

in measles, 197 

in rheumatism, 217 

significance of, 91, J 

sores, 279 

sudden rise of, 93 
Finger-nails, bluish, 164 
Fissure of the anus, 297 
Flaxseed poultice, 320 
Flies as disease carriers, 156 
Food recipes, 306 
Foot-bath, mustard, 300 
Foreign bodies in the ear, 

274 
Foreskin, tight, 292 

hygiene of, 83 
Foul breath, 60 
Freckles, lotion for, 328 
Fresh air, 12, 38 
Fright, 48 

causing vomiting, 115 
Frost-bite, 231 

G 

Games, 25 

Gas, in intestines, 3, 127 

in stomach causing foul 
breath, 60 

laxative for, 61 



Genital organs, care of, 82 
development of, 75 
male, 77 

German measles, 200 

Glands, 130, 266 

enlarged, 172. See also 

Mumps 
in diphtheria, 190 
in diphtheritic croup, 187 
in German measles, 200 
in scarlet fever, 202 
tuberculosis of, 176, 268 

Grinding of teeth, 145 

Grippe. See Influenza 

Growing pain, 214 

Growth in height and 
weight, 74 

Gruels, 312 

Gum-boil, 67 

Gums, in scurvy, 135 

Gymnastics, lung, 24, 172 



Habit-spasm, 244 
Habits, 48 

bad, 49, 51, 78 
Hair brush, 70 
Hair, care of, 68 

comb, 71 

matted, 72 
Handball, 27 
Hands, cold, 27 
Hanging or heaving, 34 
Hardening a child, 38, 92, 

132 
Headache, 257, 315 

caused by acidosis, 116 

caused by constipation, 
120 

caused by decayed teeth, 
63 



[334] 



INDEX 



Headache, caused by intes- 
tinal indigestion, 128 

caused by sore throat, 141 

in influenza, 159 

in tonsillitis, 147 

to relieve, 148 
Head, hot, 94 
Head-lice, 235, 268 
Heat, application of, 318 
Height, 74 

Heliotherapy, 17, 176 
Hemorrhage. See Bleeding 
Hernia, 265 
Hiccup, 273 
High enema, 322 
Hip-joint disease, 215 
Hives, 232 

soda-bath for, 316 
Hoarseness. See False Croup 
Hookworm disease, 291 
Hop poultice, 321 
Hot pack, 315 
Hot-water bottle, 318 

to relieve cramps, 127 
Hygiene, faulty, causing in- 
testinal indigestion, 128 

faulty, causing rickets, 
131 

of the hair and scalp, 68 

of the mouth, 62 

school, 40 

sex, 76 



Inflammation, 281 

mastoid, 160 

of joints and muscles, 216 
Inhalation, steam, 181 
Injections. See Enema 
Injuries, 280 
Inquisitiveness, 49 
Insect-bites, 222 
Insomnia, 10 

bath to relieve, 314 

caused by adenoids, 145 
Intestinal, catarrh, 10 

indigestion, 128 

neuralgia, 211 
Intubation in diphtheria, 

189 
Ipecac, syrup of, dosage, 186 
Irrigation. See Enema 
Irritability, 19 
Isolation, in croup, 189 

in diphtheria, 192 

in measles, 199 

in pinkeye, 277 

in scarlet fever, 202 

in whooping-cough, 182 
Itch, 233 
Itching, to allay, 195 

in eczema, 223, 224 

in measles, 199 

of frost-bite, 231 

of insect-bites, 222 

of ivy-poison, 230 

of the anus, 286, 297 



Ice-bag, 318 
Ice-cream, 130, 211 
Imitation, power of, 48 
Indigestion, intestinal, 128 
caused by foul air, 14 
Indoor-exercise, 29 
Infantile paralysis, 254 



Jacket, pneumonia, 321 
Jaws, deformity of, caused 

by adenoids, 143 
stiffened, in convulsions, 

245 
Joint rheumatism, 216 



[335] 



INDEX 



Joints, pain in, 214 
Junket, 308 

K 

Kidneys, function of, 4 
in scarlet fever, 203 
to stimulate, 94, 148 

Kissing, 151, 172 



Laxative, foods, 121 

for foul breath, 61 

for reduction, 111 

in diarrhea, 112 

in eczema, 224 

in influenza, 161 

to reduce fever, 92 
Lemonade, cream of tartar, 
222 

nutritious, 307 
Leucorrhea, 295 
Lice, head, 235, 268 
Lips, bluish, 164 
Lobar pneumonia, 170 
Local remedies, 313 
Loose bowels. See Diarrhea 

diet in, 97 
Lotions, 325 

Lung gymnastics, 24, 179 
Lungs, function of, 5 

M 

Malaria, 212 

Mastication, imperfect, 119, 

130 
Mastoid inflammation, 160, 

276 
Masturbation, 21, 78, 83, 287 



Matted hair, 73 
Meals. See Diet 
Measles, 196 

German, 200 
Membranous croup, 187 
Meningitis, tuberculous, 249 
Menstruation, 75, 259 
Mental breakdown, 56 
Mid-day rest, 18 
Milk, 99, 174, 305 

peptonized, 306 

teeth, 65 
Mosquito, as disease carrier, 
156 

bites, 222 
Mouth, blisters of, 279 

hygiene of, 62 

sore, 279 

wash, 325 
Mouth-breathing, 142 
Movements. See Bowels 
Mumps, 184 
Muscles, in rickets, 131 

pain in, 147, 214, 216 

tired, lotion for, 327 
Mustard foot-bath, 300, 315 

poultice, 320 
Mutton soup, 308 



N 

Nails, bluish, 164 
Nature's demands while at 

school, 43 
Nephritis, 204 

hot pack in, 315 
Nervous children, 28, 46, 55 
Nervous system, disturbance 
of, 287 

during puberty, 75 

toning of, 6, 10 



[336] 



INDEX 



Nervous vomit, 115 
Neuralgia of intestines, 211 
Night, air, 15 

cough, 151 

terrors, 251 
Niter, sweet spirits of, 94 
Nose, pinched, in adenoids, 
143 

regurgitation of food 
through, 253 

running, 142, 11,8, 196 
Nosebleed, 46, 259, 285 

in brain concussion, 249 
Nurse maid, 47, 49 
Nutrition, 95 
Nutritive enema, 324 



O 



Oatmeal bath, 316 

in eczema, 225 
Obedience, 40, 51 
Ocean bath, 9 
Oil, enema, 323 

injections, 323 
Oil-silk jacket, 321 
Ointments, 325 
One-child families, 54 
Operations, 263 
Orangeade, albuminized, 307 
Out-door life, 38 

in rickets, 132 

in tuberculous pneumonia, 
173 



Pack, wet, 315 
Pain, growing, 214 
in abdomen, 210 
in arms and legs, 216 



Pain, in joints and muscles, 
214, 216 

in neck and back, 216 
Pallor of skin, 12 
Paralysis, 253 

following diphtheria, 191 
Paregoric poisoning, 300 
Peculiarities of childhood, 47 
Peptonized milk, 306 
Perspiration, 2%, 36 

dusting powder for, 327 

lotion for, 328 
Pertussis. See Whooping- 
cough 
Pigeon-breast, 145, 172 
Pimples, lotion for, 326 
Pinkeye, 277 
Pleurisy, 152 
Pneumonia, 166 

influenzal, 160 

jacket, 321 

lobar, 170 

tuberculous, 172 
Poison-ivy, 229 
Poisons and antidotes, 298 
Poliomyelitis, 254 
Polypus, 285 
Poultices, 320 

bran, 321 

flaxseed, 320 

hop, 321 

mustard, 320 

raisin, 68 
Precocious children, 58 
Prescriptions. See Oint- 
ments and Lotions 
Puberty, 46, 75 
Puddings, 309 
Pulley-weight exercise, 29 
Punishments, 50 

corporal, 53 
Purgatives. See Laxatives 



[337] 



INDEX 



R 



S 



Raisin poultice, 68 
Rash, 94 

bringing out the, 314, 315 

in chicken-pox, 194 

in German measles, 200 

in ivy-poisoning, 230 

in measles, 197 

in scarlet fever, 201 

stomach, 221 
Rashes, 221 

food, 232 
Raw beef, scraped, 313 
Reduction diet, 110 
Remedies for local use, 313, 

325 
Restlessness, 19, 37, 250 

at night, 21 

due to adenoids, 142 

due to worms, 288 
Retention of urine, 4 
Rewards, 50 
Rheumatism, 215 
Rhinitis, 148 

caused by adenoids, 149 
Rice pudding, 310 
Rickets, 131 

causing weak ankles, 133 
Riding, bicycle, 133 
Riggs's disease, 65 
Ringworm, 227 
Roller-skates, 25 

for developing weak an- 
kles, 133 
Round shoulders, 35 
Roundworms, 288 
Rowing, 26 
Running ear, 144 

nose, 142, U8 
Rupture, 181. See also Her- 
nia 

[ 



Sago pudding, 310 
Salt bath, 316 
Scald. See Burn 
Scalp, to clean, 69 
Scarlet fever, 201 
School, 40 

boarding, 42 

exercise in, 28 

hygiene, 40 

open-air classes, 38 
Scraped beef, 313 
Sea-baths, 9 
Sea, wading in, 10 
Self-abuse, 80 
Seminal emissions, 78 
Sex-hygiene, 76 
Shampoo of the scalp, 69 

dry, 328 
Sitz bath, 296 
Skating, 26 
Skin, 3, 11 

diseases of, 221 

effect of impure air on, 12 

in erysipelas, 226 

in intestinal indigestion, 
128 

in ivy-poisoning, 229 

overheated, 36 

pallor of, 12 

peeling, in scarlet fever, 
201 
Skipping-rope, 26 
Sleep, 18 

medication during, 163 
Sleeplessness, bath for, 10 
Small-pox. Facing page 84 
Sneezing, 148 
Snoring, 142 
Soda bath, 316 

injections, 125 

338] 



INDEX 



Sore eyes, 277 

Sore mouth, 279 

Sore throat, 92, 217. See 

also Tonsillitis 
Soups, 308 

Sour breath, 116, 147 
Spasm, 245 

habit, 244 

in whooping-cough, 180 
Speech defect, 238 
Spices, 98 
Spinal douche, 80 
Spine, curvature of, 35, 255 
Splinters, 283 

Spoiled stomach, 40, 91. See 
also Vomit, also Indi- 
gestion 
Sponge bath, 313 

during menstruation, 76 
Sports and games. See 

Amusements 
Sprains, 283 
Stammering, 238 
Standing or walking, cor- 
rect, 134 
Starch enema, 323 
Staring in convulsions, 245 

in meningitis, 250 
Steam inhalation, 181 
Sties, 278 

Stimulating enema, 324 
Stimulation, alcoholic, 168 
Stomach, capacity, 99 

disordered, 115 

growth in, 115 

rash, 221, 232 

spoiled or overloaded, 91 
Stools. See also Bowels 

dry and hard, 211 

explosive, 125 

loose, 122 
Stuttering, 238 

[339 



Sulfur bath, 316 
Summer vacations, 44 
Sunburn, 230 

lotion for, 326 
Sunlight, 17 

as a disinfectant, 193, 202 

in tuberculosis, 76 
Swelling, 281 
Swimming, 26 

during menstruation, 76 
Syphilis conveyed by kiss- 
ing, 157 
Syphilitic catarrh, 150 



Tan. See Sunburn 
Tapeworm, 289 
Tapioca pudding, 310 
Taste, peculiarities in, 98 
Teeth, cleaning of, 62 

grinding of, 145, 288 

in rickets, 131 

irregular, 64 

permanent, 64, 65 

protruding, 143 
Temperature, 88. See also 
Fever 

how to take, 89 

in typhoid fever, 206 

of baths, 6 
Tennis, 26 

during menstruation, 76 
Thermometer, clinical, 89 
Thirst, in diphtheria, 191 

in measles, 196 

to quench, 148 
Throat, 139. See also 
Frontispiece 

in diphtheria, 190 

in scarlet fever, 202 

] 



INDEX 



Throat, sore, 92, 217. See 

also Tonsillitis 
Thrush, 61 
Tight foreskin, 292 
Tongue, coated, 60 

dry, 147 

in scarlet fever, 201 
Tonics, 38 

after diarrhea, 126 

nerve, 6 
Tonsillitis, 146. See also 
Frontispiece 

rheumatic, 217 
Tonsils, enlarged, 139. See 
also Frontispiece 

causing vomiting, 115 
Toothache, 67, 319 

powder, 325 
Trachoma, 279 
Tub baths, 6 

during menstruation, 76 
Tuberculosis, 173 

cough in, 153 

disinfectant in, 17 

following bronchitis, 162 

heliotherapy in, 17 
Tuberculous meningitis, 249 
Tuberculous pneumonia, 172 
Twitching, 48, 21,3 
Typhoid fever, 205 

sunlight in, as a disin- 
fectant, 17 



U 



Urine, 94 

amount passed daily, 4, 

294 
examination of, before 

operations, 264 
incontinence of, 292 
in scarlet fever, 202 



Urine, in typhoid fever, 207 

retention of, 294 

scanty, 94 
Urticaria. See Hives 



V 



Vacation, where to spend, 4 

Vaccination, 84 

Vaginitis, 287. See also 

Leucorrhea 
Veins, prominence of, on 

scalp, 251 
Ventilating window-box, 16 
Ventilation, 12 
Vermin, head, 235 
Virginia creeper. See illus- 
tration facing page 230 
Vomiting, 91, 99, 115 

in brain concussion, 249 

influenza, 159 

in scarlet fever, 201 

in tonsillitis, 147 

in whooping-cough, 180 

W 

Wading, 10, 211 
Walking, correct, 134 

jerky, 243 
Wand exercise, 28 
Warts, 234 
Washing out the bowels. 

See Enema 
Wassermann blood test, 150 
Water-ice, 130 
Weight, 74 

loss of, 19, 129, 152 
Wetting the bed, 142, 145, 

292 
Wheezing, 164, 186, 188 



[340] 



INDEX 



Whooping-cough, 151, 180 Worms, causing abdominal 

tuberculous pneumonia pain, 212 

complicating, 172 hook, 291 

Window-board, 16 tape, 289 

Worms, 21, 286 Wounds. See Injuries 



[341] 



ADVERTISEMENTS 



JUST THE BOOK FOR MOTHERS 



THE 



HEALTH-CARE 
OF THE BABY 




By LOUIS FISCHER, MD. 

Author of "Infant Feeding in Health and Disease." "A Text-book 

on Diseases of Infancy and Childhood." Attending Physician 

to the IVillard Parker and Riverside Hospitals. New York, 

Former Instructor in Diseases of Children at the New York 

Post-Graduate Medical School and Hospital, etc. 



Sixth Revised Edition. Price, Seventy-five Cents, Net 



INDISPENSABLE TO MOTHERS 

A PHYSICIAN can not always be at hand to answer 
■**• the many details which the mother requires, most 
especially if she is out of town or traveling. Sugges- 
tions and advice for infant feeding in health and when 
the stomach and bowels are out of order, form the most 
important part of this little work. Directions for the 
management of fever, and a guide during such diseases 
as measles, croup, skin diseases, etc., are given. In 
cases of accident, poisoning, etc. , ample advice is given 
until medical help can be procured. 

PART I.-GENERAL HYGIENE OF THE INFANT. I- 

The Nursery; the Bed; Ventilation; Temperature; Nursemaid 
and Toys. II— Bathing and Care op the Naval. Ill— 
Clothing; by Day and by Night; Ont-of -Doors. IV — Devel- 
opment and Growth; Growth; Weight; Exercise; Out-Door 
Life and Carriage. V— Proper Training; Bowel Movements; 
the Cry and Sleep. VI— Vaccination and Dentition (Teething). 

PART H.-INFANT FEEDING. I-General Feeding. 
II— Breast Feeding. Ill— Weaning. IV— Mixed Feeding. 
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PART HI-MISCELLANEOUS DISEASES AND EMER- 
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eases and Fevers. VI— Measles; Scarlet Fever; Diph- 
theria and Croup. Vj-i— Whooping Cough and Tonsilitis. 
VHI— Skin Disease; Eczema; Prickly Heat; Chafing; Chapped 
Hands and Face; Sunburn; Hives; Bolls; Mosquito Bites; Ring 
Worm. IX— Accidents and Emergencies; Burns; Splinters; 
Bumps and Bruises; Cuts; Foreign Bodies in the Throat, Stom- 
ach, Eye, Ear, and Nose; Poisoning; Bleeding. X— Ear and 
Eye; Earache; Running Ears; Projecting Ears; Crusted Eye- 
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Bed- Wetting; Masturbation. XH— Worms. XIII— External 
Applications and the Medicine Chest; Index. 

MMfcSJjauL .h i ii — m ivflvnmmmnwM B&aKmammmmm 



SOME OF ITS STRONG POINTS 



WILL SAVE MANY DOCTORS' CALLS 

"Every mother, especially every young mother should read and 
study it carefully. By so doing, many useful hints can be obtained 
and frequent doctors' calls for the little ones rendered unneces- 
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PLAIN AS THE ENGLISH LANGUAGE 

"A very necessary and instructive book for mothers and 
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It is as plain as the English language to one who can read." — 
Carl F. Wahrer, M.D., Fort Madison, Iowa. 

BY AN EXPERIENCED SPECIALIST 

"Dr. Fischer's experience as a specialist in the treatment of 
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INVALUABLE TO THE MOTHER, ESPECIALLY THE 
YOUNG MOTHER 

" Such a book in the hands of a mother, especially a young 
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WRITTEN SIMPLY AND PLAINLY 



" It is written so simply and plainly that it can be readily un- 
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■ II I I Ml III II I I III I ' I II l| 

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